Department of Medical Imaging, Royal Hobart Hospital, Hobart, Tasmania, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
J Neurointerv Surg. 2018 Sep;10(9):902-906. doi: 10.1136/neurintsurg-2017-013596. Epub 2018 Jan 9.
Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies.
This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms.
Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator. Dose area products (DAP), and procedure and fluoroscopy times were recorded and compared between COIL, BAC, SAC, and FDT techniques. Differences in parameters between cohorts were analyzed for significance using the Mann-Whitney U test, unpaired t test and χtest. Additional subgroup analysis was performed for emergency and elective cases.
83 aneurysms were treated with COIL (33%), 72 with BAC (29%), 61 with SAC (25%), and 33 with FDT (13%). Baseline characteristics were largely similar within these groups (P>0.05). Among COIL, BAC, and FDT cohorts, no significant difference was found for mean DAP, or procedure and fluoroscopy times (P>0.05). However, compared with all other cohorts, SAC was associated with a significantly higher DAP and longer procedure and fluoroscopy times (P<0.005). No significant difference was recorded for emergency and elective case subgroups.
Compared with other NET strategies, SAC was associated with a significantly higher DAP, and longer procedure and fluoroscopy times. This study provides an initial dataset regarding radiation exposure, and procedure and fluoroscopy times for common NET, and may assist ALARA (As Low As Reasonably Achievable) principles to reduce radiation risks.
神经血管内治疗（NET）策略中，有关辐射暴露、手术过程和透视时间的数据有限。
本研究旨在建立并比较颅内动脉瘤 NET 中线圈栓塞（COIL）、球囊辅助线圈栓塞（BAC）、支架辅助线圈栓塞（SAC）和血流导向装置（FDT）的相关参数。
2010 年至 2017 年间，249 例连续颅内动脉瘤在一家中心接受 NET 治疗，均由同一位术者完成。记录并比较 COIL、BAC、SAC 和 FDT 技术的剂量面积产品（DAP）、手术过程和透视时间，并采用 Mann-Whitney U 检验、非配对 t 检验和卡方检验分析组间参数差异的统计学意义。此外，还对急症和择期病例进行了亚组分析。
83 例动脉瘤采用 COIL（33%）、72 例采用 BAC（29%）、61 例采用 SAC（25%）、33 例采用 FDT（13%）治疗。这些组间的基线特征基本相似（P>0.05）。在 COIL、BAC 和 FDT 组中，平均 DAP、手术过程和透视时间无显著差异（P>0.05）。然而，与所有其他组相比，SAC 与更高的 DAP 和更长的手术过程和透视时间相关（P<0.005）。急症和择期病例亚组之间无显著差异。
与其他 NET 策略相比，SAC 与更高的 DAP 和更长的手术过程和透视时间相关。本研究提供了常见 NET 中有关辐射暴露、手术过程和透视时间的初始数据集，可能有助于达到合理可达到的最低辐射量（ALARA）原则，以降低辐射风险。
