Weerakkody R A, Walsh S R, Cousins C, Goldstone K E, Tang T Y, Gaunt M E
Department of Vascular Surgery, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Br J Surg. 2008 Jun;95(6):699-702. doi: 10.1002/bjs.6229.
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.
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.
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.
Radiation doses administered during EVAR were higher than previously thought, with a potential risk of radiation-induced skin damage and later malignancy.
血管内支架植入术是修复腹主动脉瘤(AAA)的一种既定选择,该手术可能需要在放射控制下进行长时间操作。目的是确定血管内动脉瘤修复术(EVAR)及术后第一年监测期间的平均辐射暴露量。
记录前瞻性辐射剂量数据,并用于计算96例行EVAR患者的剂量面积乘积(DAP)值。然后,利用DAP数据确定每位患者的入射皮肤剂量(ESD),这是潜在皮肤损伤的指标,以及有效剂量,这是长期癌症风险的指标。
EVAR期间的ESD中位数为0.85(四分位间距0.51 - 3.74)Gy。29%的手术超过了可能导致辐射性皮肤损伤的2 Gy阈值。EVAR后第一年的辐射有效剂量为79 mSv。
EVAR期间给予的辐射剂量高于先前的认知,存在辐射性皮肤损伤和后期恶性肿瘤的潜在风险。