Radiation exposure during endovascular aneurysm repair

Background: Endovascular stent-grafting is an established option for the repair of abdominal aortic aneurysm (AAA) that can involve prolonged manipulation under radiological control. The aim was to determine the average radiation exposure sustained during endovascular aneurysm repair (EVAR) and the first year of postoperative surveillance. Methods: Prospective radiation dose data were recorded and used to calculate dose area product (DAP) values for 96 patients undergoing EVAR. The DAP data were then used to determine the entrance skin dose (ESD), an indicator of potential skin damage, and the effective dose, an indicator of long-term cancer risk, for each patient. Results: The median ESD during EVAR was 0.85 (interquartile range 0.51-3-74) Gy. The threshold for possible radiation-induced skin damage of 2 Gy was exceeded in 29 per cent: of procedures. The effective dose of radiation in the first year following EVAR was 79 mSv. Conclusion: Radiation doses administered during EVAR were higher than previously thought, with a potential risk of radiation-induced skin damage and later malignancy.