Objective: To estimate radiation doses for the primarily irradiated organs/tissues of patients subjected to standard endovascular aneurysm repair (EVAR) procedures using a novel personalized dosimetry method.
Methods: Dosimetric and anthropometric data were collected prospectively for eight patients who underwent standard EVAR procedures. Patient-specific Monte Carlo simulations were performed to estimate organ/tissue doses from each of the fluoroscopic and digital subtraction angiography acquisitions involved in EVAR. Individual-specific cumulative absorbed doses were estimated for the skin, spinal bone marrow, heart, kidneys, liver, colon, bladder, pancreas, stomach, and spleen and compared to corresponding values estimated through a commercially available dosimetric software package that employs standardized phantoms.
Results: The highest organ/tissue radiation doses from EVAR were found for the skin, spinal bone marrow, kidneys, and spleen as 192.4 mGy, 96.7 mGy, 72.9 mGy, and 33.6 mGy respectively, while the doses to the heart, liver, colon, bladder, pancreas, and stomach were 6.3 mGy, 14.4 mGy, 18.4 mGy, 14.8 mGy, 21.6 mGy, and 11.2 mGy respectively. Corresponding dose values using standardized phantoms were found to differ up to 151%.
Conclusion: Considerable radiation doses may be received by primarily exposed organs/tissues during standard EVAR. The specific size/anatomy of the patient and the variation in exposure parameters/beam angulation between different projections commonly involved in EVAR procedures should be taken into account if reliable organ dose data are to be derived.
Key Points: • A novel patient-specific dosimetry method was utilized to estimate radiation doses to the primarily irradiated organs/tissues of patients subjected to standard endovascular aneurysm repair procedures. • The use of standardized mathematical anthropomorphic phantoms to derive organ dose from fluoroscopically guided procedures may result in considerable inaccuracies due to differences in the assumed organ position/volume/shape compared to patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00330-021-07789-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Para-Anastomotic Pseudoaneurysms as a Long-Term Complication After Surgical Treatment of Peripheral Artery Disease: Clinical Characteristics and Surgical Treatment.
Biomedicines
November 2024
Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 45-47 Ziołowa Street, 40-635 Katowice, Poland.
Peripheral arterial disease (PAD) is becoming an increasingly prevalent clinical issue, leading to a growing number of patients requiring surgical interventions. Consequently, there is an increasing occurrence of para-anastomotic aneurysms as late complications following primary treatment for PAD. These aneurysms typically arise at the sites of graft implantation and necessitate individualized management strategies based on factors such as location, size, and the patient's overall condition.
View Article and Find Full Text PDFThe outcome of late open conversion after endovascular abdominal aortic repair.
Asian Cardiovasc Thorac Ann
January 2025
Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.
Background: Endovascular abdominal aneurysm repair (EVAR) offers a less invasive approach to treating abdominal aortic aneurysms (AAA) compared to open repair. However, EVAR is associated with higher rates of reintervention. This study investigates the early and mid-term outcomes of patients who underwent late open conversion including aneurysmorrhaphy after EVAR at our institution.
View Article and Find Full Text PDFIntraoperative rescue of a dislodged renal stent during fenestrated endovascular aortic repair for treatment of type 1A endoleak.
J Vasc Surg Cases Innov Tech
February 2025
Division of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, Integrated University Healthcare Giuliano-Isontina, University Hospital of Cattinara, Trieste, Italy.
In the past 15 years, fenestrated-branched endovascular aortic repair (F-BEVAR) has progressively become the first-line option for management of most complex abdominal aortic aneurysms (AAAs); with increasing experience, as well as persistent technological refinements, F-BEVAR indications have been expanded to include rescue of failures after prior EVAR. Despite the feasibility and effectiveness, F-BEVAR procedures in the presence of prior infrarenal endografts may come with higher technical complexity that should be properly anticipated, and several anatomical challenges can be expected. Among these, presence of suprarenal bare stents from prior EVAR device are certainly a frequent scenario and may sometimes make target vessel cannulation more difficult because of encroachment on the target vessel origins.
View Article and Find Full Text PDFTranscaval embolisation of type-II endoleaks - The Australian experience.
Vascular
January 2025
Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, QLD, Australia.
Objectives: Embolizing an abdominal aortic aneurysm sac through a transcaval approach is a novel approach to treat type-II endoleaks that occur following aortic endografting. This study reviews the outcomes of this treatment in one of the few centres in Australia that offers this procedure.
Methods: A retrospective cohort study was conducted, including patients who had received transcaval embolisation of type-II endoleak over a 9-year period.
Endograft-specific hemodynamics after endovascular aneurysm repair: a CFD analysis.
Sci Rep
December 2024
Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Intraluminal prosthetic graft thrombus (IPT) has been described in case of endovascular aortic pathology repair. This study aimed to assess hemodynamic indicators associated with various anatomical morphologies following endovascular aortic repair (EVAR), aiming to offer further references for the choice of clinical therapy. Six model models (normal, iliac compression, aortic compression, aortoiliac compression, iliac distortion, and long-leg stent) were established based on common anatomical morphologies following EVAR.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!