Survey of practice and patient doses in endovascular and hybrid revascularization of the lower extremities
- Kostova-Lefterova, N. Nikolov, S. Stanev, B. Stoyanova, K. Genova
Hybrid surgery (mostly remote endarterectomy) and endovascular revascularization are fluoroscopy guided procedures. They replace conventional surgery as a method of treating peripheral arterial disease (PAD). One of the drawbacks of such procedures is that patients undergoing endovascular revascularization of the lower extremities can be potentially exposed to higher radiation doses. The purpose of this study was to survey the relationship between patient dose (KAP, Gy.cm2), vascular access, type of procedure and number of inserted stents for patients undergoing endovascular or hybrid revascularization of the lower limb below the inguinal ligament. Data for 327 patients was recorded retrospectively during the survey and 259 patients were included in the final analysis of the results. The procedures were grouped based on vascular access, type of intervention and the level of complexity of the procedure. The KAP and FT values vary widely depending on the procedure type but also among patients undergoing the same procedure. Registered dose values and fluoroscopy time for the different procedures, disregarding their complexity, do not exceed the IAEA (International Atomic Energy Agency) proposed trigger values for patients’ follow-up for radiation induced skin injuries. The results of the study showed that vascular access had the greatest impact on the patient’s dose. There was a significant increase in KAP values with the increase in the number of inserted stents and the level of complexity of the procedures.
Key words: ENDOVASCULAR. REVASCULARIZATION. HYBRID REVASCULARIZATION. PATIENT DOSIMETRY. KAP. PSD