FACTORS INFLUENCING FLUOROSCOPY TIME IN ENDOVASCULAR TREATMENT OF ABDOMINAL ANEURYSMS: A RETROSPECTIVE STUDY

Author:

Efthymiou Fotios O1,Kakkos Stavros K2,Metaxas Vasileios I1,Dimitroukas Christos P13ORCID,Moulakakis Konstantinos G2,Papadoulas Spyros I2,Kouri Natasa K2,Tsimpoukis Andreas L2,Nikolakopoulos Konstantinos M2,Papageorgopoulou Chrysanthi P2,Panayiotakis George S13ORCID

Affiliation:

1. Department of Medical Physics, School of Medicine, University of Patras , Patras , Greece

2. Department of Vascular Surgery, School of Medicine, University of Patras , Patras , Greece

3. Department of Medical Physics, University Hospital of Patras , Patras , Greece

Abstract

Abstract Patients who undergo endovascular aortic aneurysm repair (EVAR) may require prolonged radiation exposure affected by several factors. The objectives of this study were to document fluoroscopy time (FT) during EVAR and identify possible factors that influence it. A retrospective analysis of a 180 patients’ database with abdominal infrarenal aortic aneurysms submitted to EVAR during a 7-y period was performed. The FT is evaluated regarding risk factors and comorbidities, graft type and patient-related, clinical and technical parameters. FT’s median (interquartile range) was 1011 (698–1500) s. Excluder and C3 Excluder were associated with significantly lower FT values when compared with other grafts. Hypertension, dyslipidemia, age ≥ 70 y, maximum aneurysm diameter ≥ 6 cm and procedure duration ≥2 h resulted in higher FT values. A significantly lower FT was found for the operations performed in the 7th y of the study’s period compared with the previous 6 y, mainly because of the use of Excluder or C3 Excluder grafts. However, these grafts did not show any significant difference in FT values during the 7 y. A significant correlation between FT with age and procedure duration was found. Nevertheless, procedure duration is a poor FT predictor in linear and logistic regressions, although is significantly correlated with FT. Dyslipidemia, procedure duration and graft type are independent predictors of FT larger than the median, whereas only the procedure duration is a predictor for FT larger than the 75th percentile value. The identified factors regarding radiation protection issues should be considered when contemplating abdominal aortic aneurysm repair, however, without compromising the procedure’s efficacy. Further work is necessary to identify more potential anatomical, clinical and technical factors affecting procedures’ complexity and FT and patient radiation dose during EVAR interventions.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,Radiology, Nuclear Medicine and imaging,General Medicine,Radiation,Radiological and Ultrasound Technology

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