Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?

Evan C. Lipsitz, Frank J. Veith, Takao Ohki, Sherman Heller, Reese A. Wain, William D. Suggs, John C. Lee, Stephanie Kwei, Kenneth Goldstein, Joseph Rabin, David Chang, Manish Mehta

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Objectives: Endovascular aortoiliac aneurysm (EAIA) repair uses substantial fluoroscopic guidance that requires considerable radiation exposure. Doses were determined for a team of three vascular surgeons performing 47 consecutive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. Methods: Twenty-nine surgeon-made aortounifemoral devices and 18 bifurcated devices were used. Three surgeons wore dosimeters (1) on the waist, under a lead apron; (2) on the waist, outside a lead apron; (3) on the collar; and (4) on the left ring finger. Dosimeters were also placed around the operating table and room to evaluate the patient, other personnel, and ambient doses. Exposures were compared with standards of the International Commission on Radiological Protection (ICRP). Results: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 minutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outside lead doses for two surgeons approximated recommended limits. Lead aprons attenuated 85% to 91% of the dose. Ring doses and calculated eye doses were within the ICRP exposure limits. Patient skin doses averaged 360 mSv per case (range, 120-860 mSv). The ambient (> 3 m from the source) operating room dose was 1.06 mSv/y. Conclusions: Although the total effective body doses under lead fell within established ICRP occupational exposure limits, they are not negligible. Because radiation exposure is cumulative and endovascular procedures are becoming more common, individuals performing these procedures must carefully monitor their exposure. Our results indicate that a team of surgeons can perform 386 hours of fluoroscopy per year or 587 EAIA repairs per year and remain within occupational exposure limits. Individuals who perform these procedures should actively monitor their effective doses and educate personnel in methods for reducing exposure.

Original languageEnglish (US)
Pages (from-to)704-710
Number of pages7
JournalJournal of Vascular Surgery
Volume32
Issue number4
DOIs
StatePublished - 2000

Fingerprint

Aneurysm
Blood Vessels
Radiation
Safety
Occupational Exposure
Fluoroscopy
Operating Tables
Equipment and Supplies
Endovascular Procedures
Operating Rooms
Fingers
Surgeons
Lead
Skin
Radiation Dosimeters
Radiation Exposure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons? / Lipsitz, Evan C.; Veith, Frank J.; Ohki, Takao; Heller, Sherman; Wain, Reese A.; Suggs, William D.; Lee, John C.; Kwei, Stephanie; Goldstein, Kenneth; Rabin, Joseph; Chang, David; Mehta, Manish.

In: Journal of Vascular Surgery, Vol. 32, No. 4, 2000, p. 704-710.

Research output: Contribution to journalArticle

Lipsitz, EC, Veith, FJ, Ohki, T, Heller, S, Wain, RA, Suggs, WD, Lee, JC, Kwei, S, Goldstein, K, Rabin, J, Chang, D & Mehta, M 2000, 'Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?', Journal of Vascular Surgery, vol. 32, no. 4, pp. 704-710. https://doi.org/10.1067/mva.2000.110053
Lipsitz, Evan C. ; Veith, Frank J. ; Ohki, Takao ; Heller, Sherman ; Wain, Reese A. ; Suggs, William D. ; Lee, John C. ; Kwei, Stephanie ; Goldstein, Kenneth ; Rabin, Joseph ; Chang, David ; Mehta, Manish. / Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?. In: Journal of Vascular Surgery. 2000 ; Vol. 32, No. 4. pp. 704-710.
@article{3d3b899d75704874afbefdc0926f74b1,
title = "Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?",
abstract = "Objectives: Endovascular aortoiliac aneurysm (EAIA) repair uses substantial fluoroscopic guidance that requires considerable radiation exposure. Doses were determined for a team of three vascular surgeons performing 47 consecutive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. Methods: Twenty-nine surgeon-made aortounifemoral devices and 18 bifurcated devices were used. Three surgeons wore dosimeters (1) on the waist, under a lead apron; (2) on the waist, outside a lead apron; (3) on the collar; and (4) on the left ring finger. Dosimeters were also placed around the operating table and room to evaluate the patient, other personnel, and ambient doses. Exposures were compared with standards of the International Commission on Radiological Protection (ICRP). Results: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 minutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outside lead doses for two surgeons approximated recommended limits. Lead aprons attenuated 85{\%} to 91{\%} of the dose. Ring doses and calculated eye doses were within the ICRP exposure limits. Patient skin doses averaged 360 mSv per case (range, 120-860 mSv). The ambient (> 3 m from the source) operating room dose was 1.06 mSv/y. Conclusions: Although the total effective body doses under lead fell within established ICRP occupational exposure limits, they are not negligible. Because radiation exposure is cumulative and endovascular procedures are becoming more common, individuals performing these procedures must carefully monitor their exposure. Our results indicate that a team of surgeons can perform 386 hours of fluoroscopy per year or 587 EAIA repairs per year and remain within occupational exposure limits. Individuals who perform these procedures should actively monitor their effective doses and educate personnel in methods for reducing exposure.",
author = "Lipsitz, {Evan C.} and Veith, {Frank J.} and Takao Ohki and Sherman Heller and Wain, {Reese A.} and Suggs, {William D.} and Lee, {John C.} and Stephanie Kwei and Kenneth Goldstein and Joseph Rabin and David Chang and Manish Mehta",
year = "2000",
doi = "10.1067/mva.2000.110053",
language = "English (US)",
volume = "32",
pages = "704--710",
journal = "Journal of Vascular Surgery",
issn = "0741-5214",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Does the endovascular repair of aortoiliac aneurysms pose a radiation safety hazard to vascular surgeons?

AU - Lipsitz, Evan C.

AU - Veith, Frank J.

AU - Ohki, Takao

AU - Heller, Sherman

AU - Wain, Reese A.

AU - Suggs, William D.

AU - Lee, John C.

AU - Kwei, Stephanie

AU - Goldstein, Kenneth

AU - Rabin, Joseph

AU - Chang, David

AU - Mehta, Manish

PY - 2000

Y1 - 2000

N2 - Objectives: Endovascular aortoiliac aneurysm (EAIA) repair uses substantial fluoroscopic guidance that requires considerable radiation exposure. Doses were determined for a team of three vascular surgeons performing 47 consecutive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. Methods: Twenty-nine surgeon-made aortounifemoral devices and 18 bifurcated devices were used. Three surgeons wore dosimeters (1) on the waist, under a lead apron; (2) on the waist, outside a lead apron; (3) on the collar; and (4) on the left ring finger. Dosimeters were also placed around the operating table and room to evaluate the patient, other personnel, and ambient doses. Exposures were compared with standards of the International Commission on Radiological Protection (ICRP). Results: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 minutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outside lead doses for two surgeons approximated recommended limits. Lead aprons attenuated 85% to 91% of the dose. Ring doses and calculated eye doses were within the ICRP exposure limits. Patient skin doses averaged 360 mSv per case (range, 120-860 mSv). The ambient (> 3 m from the source) operating room dose was 1.06 mSv/y. Conclusions: Although the total effective body doses under lead fell within established ICRP occupational exposure limits, they are not negligible. Because radiation exposure is cumulative and endovascular procedures are becoming more common, individuals performing these procedures must carefully monitor their exposure. Our results indicate that a team of surgeons can perform 386 hours of fluoroscopy per year or 587 EAIA repairs per year and remain within occupational exposure limits. Individuals who perform these procedures should actively monitor their effective doses and educate personnel in methods for reducing exposure.

AB - Objectives: Endovascular aortoiliac aneurysm (EAIA) repair uses substantial fluoroscopic guidance that requires considerable radiation exposure. Doses were determined for a team of three vascular surgeons performing 47 consecutive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. Methods: Twenty-nine surgeon-made aortounifemoral devices and 18 bifurcated devices were used. Three surgeons wore dosimeters (1) on the waist, under a lead apron; (2) on the waist, outside a lead apron; (3) on the collar; and (4) on the left ring finger. Dosimeters were also placed around the operating table and room to evaluate the patient, other personnel, and ambient doses. Exposures were compared with standards of the International Commission on Radiological Protection (ICRP). Results: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 minutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outside lead doses for two surgeons approximated recommended limits. Lead aprons attenuated 85% to 91% of the dose. Ring doses and calculated eye doses were within the ICRP exposure limits. Patient skin doses averaged 360 mSv per case (range, 120-860 mSv). The ambient (> 3 m from the source) operating room dose was 1.06 mSv/y. Conclusions: Although the total effective body doses under lead fell within established ICRP occupational exposure limits, they are not negligible. Because radiation exposure is cumulative and endovascular procedures are becoming more common, individuals performing these procedures must carefully monitor their exposure. Our results indicate that a team of surgeons can perform 386 hours of fluoroscopy per year or 587 EAIA repairs per year and remain within occupational exposure limits. Individuals who perform these procedures should actively monitor their effective doses and educate personnel in methods for reducing exposure.

UR - http://www.scopus.com/inward/record.url?scp=0033786756&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033786756&partnerID=8YFLogxK

U2 - 10.1067/mva.2000.110053

DO - 10.1067/mva.2000.110053

M3 - Article

C2 - 11013034

AN - SCOPUS:0033786756

VL - 32

SP - 704

EP - 710

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

SN - 0741-5214

IS - 4

ER -