This study clearly depicts that , ALARA (as low as reasonably achievable) is the guiding principle in radiation (XR) safety, but there is a lack of standardization of XR protocols. Given the longitudinal effects of continued XR exposure on providers’ life-time risk of XR-induced carcinoma and cataract formation, there is a need to establish an imaging standard that minimizes occupational risks without sacrificing image quality. We used an imaging protocol with a reduced frame rate (Fr) and roentgen (R) to assess patient and occupational XR exposure in a hybrid fixed imaging suite for endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR). A retrospective analysis was conducted of occupational XR dose of operating room (OR) personnel and patients before and after implementation of a modified preset imaging protocol from 15 Fr/5 R to 7.5 Fr/2.5 R during 2018 to 2020. All OR staff wore XR dosimetry badges to record monthly dose equivalent levels: lens, shallow, and deep. Patient XR dose was calculated by air kerma and dose-area product. Wilcoxon rank sum test demonstrated significance (P < .05).

With the expansion of complex endovascular procedures, measures should be taken to minimize the harmful effects of lifelong XR. This study demonstrates a significant reduction in XR dose in both patients and OR staff for both TEVAR and EVAR procedures with the use of a 7.5 Fr/2.5 R imaging protocol in fixed imaging. We aim to establish a guideline to mitigate the longitudinal effects of XR for staff and patients.

Reference link- https://www.jvascsurg.org/article/S0741-5214(20)31448-8/fulltext

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