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

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 consec utive EAIA repairs over a 1-year period to determine whether this exposure constitutes a radiation hazard. Methods: Twenty-nine surgeon-made aortounifemoral devices and Is 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; an d (4) on the left ring finger. Dosimeters were also placed around the opera ting table and room to evaluate the patient, other personnel, and ambient d oses. Exposures were compared With standards of the International Commissio n on Radiological Protection (ICRP). Results: Total fluoroscopy time was 30.9 hours (1852 minutes; mean, 39.4 mi nutes per case). Yearly total effective body doses for all surgeons (under lead) were below the 20 mSv/y occupational exposure limit of the ICRP. Outs ide lead doses for two surgeons approximated recommended limits. Lead apron s attenuated 85% to 91% of the dose. Ring doses and calculated eye doses we re within the ICRT! exposure limits. Patient skin doses averaged 360 mSv pe r 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. Be cause radiation exposure is cumulative and endovascular procedures are beco ming more common, individuals performing these procedures must carefully mo nitor their exposure. Our results indicate that a team of surgeons can perf orm 386 hours of fluoroscopy per year or 587 EAIA repairs per year and rema in within occupational exposure limits. Individuals who perform these proce dures should actively monitor their effective doses and educate personnel i n methods for reducing exposure.