MO-E-332-04: Comparison of Dose-Area-Product (DAP) and Fluoroscopy Time Between a Mobile and a Fixed C-Arm Unit for Electrophysiology (EP) Procedures

2008 ◽  
Vol 35 (6Part20) ◽  
pp. 2879-2879
Author(s):  
A Dohatcu ◽  
D Bednarek ◽  
S Rudin
Keyword(s):  
Fluoroscopy Time ◽  
Dose Area Product ◽  
Area Product

scholarly journals Radiation Dose and Fluoroscopy Time of Endovascular Treatment in Patients with Intracranial Lateral Dural Arteriovenous Fistulae

2020 ◽  
Author(s):  
Robert Forbrig ◽  
Robert Stahl ◽  
Lucas L. Geyer ◽  
Yigit Ozpeynirci ◽  
Thomas Liebig ◽  
...  
Keyword(s):  
Low Dose ◽  
Endovascular Embolization ◽  
Fluoroscopy Time ◽  
Low Grade ◽  
Endovascular Technique ◽  
Dose Area Product ◽  
Single Center Study ◽  
Life Threatening ◽  
Area Product ◽  
Dosimetry Data

Abstract Purpose Intracranial lateral dural arteriovenous fistula (LDAVF) represents a specific subtype of cerebrovascular fistulae, harboring a potentially life-threatening risk of brain hemorrhage. Fluoroscopically guided endovascular embolization is the therapeutic gold standard. We provide detailed dosimetry data to suggest novel diagnostic reference levels (DRL). Methods Retrospective single-center study of LDAVFs treated between January 2014 and December 2019. Regarding dosimetry, the dose area product (DAP) and fluoroscopy time were analyzed for the following variables: Cognard scale grade, endovascular technique, angiographic outcome, and digital subtraction angiography (DSA) protocol. Results A total of 70 patients (19 female, median age 65 years) were included. Total median values for DAP and fluoroscopy time were 325 Gy cm2 (25%/75% percentile: 245/414 Gy cm2) and 110 min (68/142min), respectively. Neither median DAP nor fluoroscopy time were significantly different when comparing low-grade with high-grade LDAVF (Cognard I + IIa versus IIb–V; p > 0.05, each). Transvenous coil embolization yielded the lowest dosimetry values, with significantly lower median values when compared to a combined transarterial/transvenous technique (DAP 290 Gy cm2 versus 388 Gy cm2, p = 0.031; fluoroscopy time 85 min versus 170 min, p = 0.016). A significant positive correlation was found between number of arterial feeders treated by liquid embolization and both DAP (rs = 0.367; p = 0.010) and fluoroscopy time (rs = 0.295; p = 0.040). Complete LDAVF occlusion was associated with transvenous coiling (p = 0.001). A low-dose DSA protocol yielded a 20% reduction of DAP (p = 0.021). Conclusion This LDAVF study suggests several local DRLs which varied substantially dependent on the endovascular technique and DSA protocol.

Analysis of Radiation Exposure during Endovascular Aneurysm Repair

2012 ◽  
Vol 78 (10) ◽  
pp. 1029-1032 ◽  
Author(s):  
Michael Butler ◽  
Madhukar S. Patel ◽  
Samuel E. Wilson
Keyword(s):  
Radiation Exposure ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysm Repair ◽  
Fluoroscopy Time ◽  
Potential Hazard ◽  
Dose Area Product ◽  
Contrast Volume ◽  
Using Data ◽  
Area Product ◽  
Aneurysm Repair

Endovascular aneurysm repair (EVAR) is now the preferred procedure for abdominal aortic aneurysm repair. As a result of the need for fluoroscopy during EVAR, radiation exposure is a potential hazard. We studied the quantity of radiation delivered during EVAR to identify risks for excessive exposure. Fluoroscopy time, contrast volume used, and procedural details were recorded prospectively during EVARs. Using data collected from similar EVARs, an equation was derived to calculate approximate dose-area product (DAP) from fluoroscopy time. DAP values were then compared between procedures in which a relevant postdeployment procedure (PDP) was necessary intraoperatively with those without. Clinical data on 17 patients were collected. The mean age of patients was 68 (±9) years. Fluoroscopy times and approximate DAP values were found to be significantly higher in the seven patients with a PDP compared with the 10 patients without an intraoperative PDP (31.2 [±9.6] vs 22.7 [±6.0] minutes, P = 0.033 and 537 [±165] vs 390 [±103] Gy-cm2, P = 0.033, respectively). The average amount of contrast volume used was not significantly different between groups. Radiation emitted during EVARs with PDPs was significantly greater relative to those without PDPs. Device design and operators should thus aim to decrease PDPs and to minimize fluoroscopy time.

scholarly journals Mortality after mechanical thrombectomy in anterior circulation stroke may be higher at nighttime and on weekends

2020 ◽  
Author(s):  
C. Zaeske ◽  
L. Goertz ◽  
J. Kottlors ◽  
M. Schlamann ◽  
O. A. Onur ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Mechanical Thrombectomy ◽  
Fluoroscopy Time ◽  
Anterior Circulation ◽  
Technical Aspects ◽  
Dose Area Product ◽  
Dosimetric Data ◽  
Key Points ◽  
Procedural Time ◽  
Area Product

Abstract Objectives The objective of this study was to compare clinical outcome and procedural differences of mechanical thrombectomy (MT) during on-call with regular operating hours. We particularly focused on dosimetric data which may serve as potential surrogates for patient outcome. Methods A total of 246 consecutive patients who underwent MT in acute anterior circulation stroke between November 2017 and March 2020 were retrospectively included. Patients treated (1) during standard operational hours (n = 102), (2) daytime on-call duty (n = 38) and (3) nighttime on-call duty (n = 106) were compared with respect to their pre-interventional status, procedural specifics, including dosimetrics (dose area product (DAP), fluoroscopy time and procedural time), and outcome. Results The collectives treated outside the regular operational hours showed an increased in-hospital mortality (standard operational hours 7% (7/102), daytime on-call duty 16% (6/38), nighttime on-call duty 20% (21/106), p = 0.02). Neither the dosimetric parameters nor baseline characteristics other procedural specifics and outcome parameters differed significantly between groups (p > 0.05 each). In most cases (> 90%), a successful reperfusion was achieved (TICI ≥ 2b). Conclusions We found an increased in-hospital mortality in patients admitted at night and during weekends which was not explained by technical aspects of MT. Key Points • There is an increased mortality of stroke patients admitted at night and on weekends. • This is not explained by technical aspects of mechanical thrombectomy. • There were no statistical differences in the comparison of parameters linked to the radiation exposure, such as DAP, fluoroscopy time and procedure time.

Using 7.5 frames per second reduces radiation exposure in lower extremity peripheral vascular interventions

Vascular ◽  
2014 ◽  
Vol 23 (3) ◽  
pp. 240-244 ◽  
Author(s):  
Nuri I Akkus ◽  
George S Mina ◽  
Abdulrahman Abdulbaki ◽  
Fereidoon Shafiei ◽  
Neeraj Tandon
Keyword(s):  
Radiation Dose ◽  
Radiation Exposure ◽  
Success Rate ◽  
Frame Rate ◽  
Fluoroscopy Time ◽  
Peripheral Vascular ◽  
Dose Area Product ◽  
Group A ◽  
Group B ◽  
Area Product

Background Peripheral vascular interventions can be associated with significant radiation exposure to the patient and the operator. Objective In this study, we sought to compare the radiation dose between peripheral vascular interventions using fluoroscopy frame rate of 7.5 frames per second (fps) and those performed at the standard 15 fps and procedural outcomes. Methods We retrospectively collected data from consecutive 87 peripheral vascular interventions performed during 2011 and 2012 from two medical centers. The patients were divided into two groups based on fluoroscopy frame rate; 7.5 fps (group A, n = 44) and 15 fps (group B, n = 43). We compared the demographic, clinical, procedural characteristics/outcomes, and radiation dose between the two groups. Radiation dose was measured as dose area product in micro Gray per meter square. Results Median dose area product was significantly lower in group A (3358, interquartile range (IQR) 2052–7394) when compared to group B (8812, IQR 4944–17,370), p < 0.001 with no change in median fluoroscopy time in minutes (18.7, IQR 11.1–31.5 vs. 15.7, IQR 10.1–24.1), p = 0.156 or success rate (93.2% vs. 95.3%), p > 0.999. Conclusion Using fluoroscopy at the rate of 7.5 fps during peripheral vascular interventions is associated with lower radiation dose compared to the standard 15 fps with comparable success rate without associated increase in the fluoroscopy time or the amount of the contrast used. Therefore, using fluoroscopy at the rate of 7.5 fps should be considered in peripheral vascular interventions.

Radiation dose monitoring in pediatric fluoroscopy: comparison of fluoroscopy time and dose–area product thresholds for identifying high-exposure cases

2019 ◽  
Vol 49 (5) ◽  
pp. 600-608
Author(s):  
Matthew S. Lazarus ◽  
Benjamin H. Taragin ◽  
William Malouf ◽  
Terry L. Levin ◽  
Eduardo Nororis ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Fluoroscopy Time ◽  
High Exposure ◽  
Dose Area Product ◽  
Dose Monitoring ◽  
Radiation Dose Monitoring ◽  
Area Product

scholarly journals What factors affect fluoroscopy use during Bernese periacetabular osteotomy for acetabular dysplasia?

2019 ◽  
Vol 6 (3) ◽  
pp. 259-264
Author(s):  
James D Wylie ◽  
Michael P McClincy ◽  
Evan K Stieler ◽  
Michael B Millis ◽  
Young-Jo Kim ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Acetabular Dysplasia ◽  
Periacetabular Osteotomy ◽  
Male Gender ◽  
Fluoroscopy Time ◽  
Linear Modeling ◽  
Factors Affecting ◽  
Dose Area Product ◽  
Area Product ◽  
Open Arthrotomy

Abstract Periacetabular osteotomy (PAO) is the treatment of choice for acetabular dysplasia in the skeletally mature. Little is known about factors affecting fluoroscopy use in PAO. Therefore, we strived to determine patient and surgery factors are associated with the amount of fluoroscopy time and radiation dose during PAO. We performed a retrospective review of 378 patients who underwent PAO between January 2012 and August 2017. The mean age was 21.7 years and 326 (86%) were females. A total of 85 patients underwent concomitant arthroscopy and 60 underwent open arthrotomy. We recorded fluoroscopy time in minutes and radiation dose area product (DAP) in mGy·m2. Multivariate general linear modeling identified independent predictors of fluoroscopy time and radiation dose. Mean fluoroscopy time was 1.21 minutes and mean fluoroscopy DAP was 0.71 mGy·m2. Multivariate predictors of increased fluoroscopy time were male gender (P = 0.001), surgeon (P < 0.001) and whether an arthroscopy was performed (P < 0.001). Multivariate predictors of increased fluoroscopy DAP were increased body mass index (BMI) (P = 0.001), surgeon (P < 0.001) and whether an arthroscopy was performed (P < 0.001). Patients undergoing hip arthroscopy concomitant to PAO are at higher risk of longer fluoroscopy time and higher radiation dose. Other factors affecting fluoroscopy time included male gender and surgeon, while radiation dose was further affected by surgeon and BMI. Our findings can facilitate discussion about the risk of radiation exposure during PAO.

scholarly journals Coronary Angiography Safety between Transradial and Transfemoral Access

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Santosh Kumar Sinha ◽  
Vikas Mishra ◽  
Nasar Afdaali ◽  
Mukesh Jitendra Jha ◽  
Ashutosh Kumar ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Vascular Complications ◽  
Fluoroscopy Time ◽  
Transfemoral Approach ◽  
Transradial Approach ◽  
Dose Area Product ◽  
Medical College ◽  
Coronary Catheterization ◽  
Standard Population ◽  
Area Product

Background and Aim. The aim of study was to evaluate safety, feasibility, and procedural variables of transradial approach compared with transfemoral approach in a standard population of patients undergoing coronary catheterization as one of the major criticisms of the transradial approach is that it takes longer overall procedure and fluoroscopy time, thereby causing more radiation exposure. Method. Between January 2015 and December 2015, a total of 1,997 patients in LPS Institute of Cardiology, GSVM Medical College, Kanpur, UP, India, undergoing coronary catheterization were randomly assigned to the transradial or transfemoral approach. Result. Successful catheterization was achieved in 1045 of 1076 patients (97.1%) in the transradial group and in 918 of 921 patients (99.7%) in the transfemoral group (p=0.001). Comparing the transradial and transfemoral approaches, fluoroscopy time (2.46±1.22 versus 2.83±1.31 min; p=0.32), procedure time (8.89±2.72 versus 9.33±2.82 min; p=0.56), contrast volume (67.52±22.54 versus 71.63±25.41 mL; p=0.32), radiation dose as dose area product (24.2±4.21 versus 22.3±3.46 Gycm2; p=0.43), and postprocedural rise of serum creatinine (6±4.5% versus 8±2.6%; p=0.41) were not significantly different while vascular access site complications were significantly lower in transradial group than transfemoral group (3.9% versus 7.6%; p=0.04). Conclusion. The present study shows that transradial access for coronary angiography is safe among patients compared to transfemoral access with lower rate of local vascular complications.

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