1Bar Velan,1Yvonne Tsitsiou, 1Yvonne Tsitsiou, 1Sophie Peregrine, 2Rishabh Gupta, 1Rishabh Gupta, 1Mohamad Hamady

1Imperial College Healthcare NHS Trust, 2Imperial College London

Objective(s):

To assess current practice in standard and complex endovascular aortic repair (EAR) and formulate local guidelines to improve radiation protection for operators and patients.

Material(s) and Method(s):

Data was collected from PACS and electronic patient records for all patients undergoing EAR over a period of 2 years. Procedure details included; complexity, theatre time, fluoroscopy time, radiation dose, machine information and operator were collected and analysed using Microsoft Excel sheets and IBM SPSS Statistics 27. Normality tests were carried out and Kruska-Wallis Tests were used to compare non-parametric data.

Result(s):

Median fluoroscopy times of EVAR, TEVAR and Complex procedures were 18:58, 11:12 and 44:23 (mm:ss) and dose of 44.75, 69.81 and 109.5mGycm2, respectively.

Based on machine types, the radiation doses were A) 91.7mGycm2, B) 63.8mGycm2 and C) portable C-arm 20.2mGycm2 (p=0.004). Complex procedure doses were A) 179mGycm2, B)103.29mGycm2 and C) portable C-arm 25.35mGycm2 (p=0.041) respectively.

There was also inter-operator differences in fluoroscopy time during EVAR procedures (p=0.008) as well as time and doses during complex procedures (p=0.013 and p=0.03 respectively).

Conclusion(s):

TEVAR and complex procedures were associated with higher radiation doses and fluoroscopy time. Significant variations were observed in relation to machine type and inter-operator parameters. Recommendations to refine performance and machine settings will be discussed.