Occupational Radiation Exposure During Endovascular Aortic Repair

Anna M. Sailer*, Geert Willem H. Schurink, Martine E. Bol, Michiel W. de Haan, Willem H. van Zwam, Joachim E. Wildberger, Cecile R. L. P. N. Jeukens

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The aim of the study was to evaluate the radiation exposure to operating room personnel and to assess determinants for high personal doses during endovascular aortic repair. Occupational radiation exposure was prospectively evaluated during 22 infra-renal aortic repair procedures (EVAR), 11 thoracic aortic repair procedures (TEVAR), and 11 fenestrated or branched aortic repair procedures (FEVAR). Real-time over-lead dosimeters attached to the left breast pocket measured personal doses for the first operators (FO) and second operators (SO), radiology technicians (RT), scrub nurses (SN), anesthesiologists (AN), and non-sterile nurses (NSN). Besides protective apron and thyroid collar, no additional radiation shielding was used. Procedural dose area product (DAP), iodinated contrast volume, fluoroscopy time, patient's body weight, and C-arm angulation were documented. Average procedural FO dose was significantly higher during FEVAR (0.34 +/- A 0.28 mSv) compared to EVAR (0.11 +/- A 0.21 mSv) and TEVAR (0.06 +/- A 0.05 mSv; p = 0.003). Average personnel doses were 0.17 +/- A 0.21 mSv (FO), 0.042 +/- A 0.045 mSv (SO), 0.019 +/- A 0.042 mSv (RT), 0.017 +/- A 0.031 mSv (SN), 0.006 +/- A 0.007 mSv (AN), and 0.004 +/- A 0.009 mSv (NSN). SO and AN doses were strongly correlated with FO dose (p = 0.003 and p <0.001). There was a significant correlation between FO dose and procedural DAP (R = 0.69, p <0.001), iodinated contrast volume (R = 0.67, p <0.001) and left-anterior C-arm projections > 60A degrees (p = 0.02), and a weak correlation with fluoroscopy time (R = 0.40, p = 0.049). Average FO dose was a factor four higher than SO dose. Predictors for high personal doses are procedural DAP, iodinated contrast volume, and left-anterior C-arm projections greater than 60A degrees.
Original languageEnglish
Pages (from-to)827-832
JournalCardiovascular and Interventional Radiology
Issue number4
Publication statusPublished - Aug 2015


  • Endovascular procedures
  • Radiation dosage
  • Radiation dosimetry

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