Analysis of Fluoroscopy use During Endovascular Procedures to Improve Radiation Safety
Jesse Victory, DO, Anjeza Zholanji, DO, Lady Velez, Enrico Ascher, MD, Anil Hingorani, MD.
NYU Lutheran Medical Center, Brooklyn, NY, USA.
To determine whether differences exist in fluoroscopy time and radiation exposure during lower extremity endovascular procedures performed by fellowship trained vascular surgeons and general surgeons, with the goal of minimizing radiation exposure to all operating room staff.
A retrospective review was performed of all lower extremity endovascular procedures from August 1st, 2014 to January 29th, 2016 by surgeons with endovascular privileges. The procedures were separated into 2 groups: vascular fellowship trained, or general surgery. Only procedures involving diagnostic angiograms, balloon angioplasty, stenting, or atherectomy were included. The operative records for for each case were reviewed. The fluoroscopy time, and total radiation dose for each procedure was recorded, and procedures were grouped according to the number of endovascular interventions performed. Statistical analysis was performed with a p-value of <0.05 defined as significant.
271 lower extremity endovascular procedures were performed during the study period. The average age was 70 years. The mean number of procedures performed over the study period were 112, 45, 23, and 91 for surgeons 1-4 respectively. On average, 3.24 interventions were performed during each procedure. Vascular surgeons were found to have shorter fluoroscopy time for procedures involving 1-2 (p<0.01), 3-4 (p<0.01), and >4 (p<0.01) interventions. Procedures by vascular surgeons were also found to have less radiation exposure in procedures with 1-2 (p<0.01) and >4 (p<0.01) interventions. There was no significant difference in radiation exposure between vascular and general surgeons for procedures with 3-4 interventions (p=0.95).
Lower extremity endovascular procedures performed by fellowship trained vascular surgeons were associated with a decreased operative fluoroscopy time and radiation exposure when compared to general surgeons.
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