Rehman Zia Ur, Choksy Sohail, Howard Adam, Carter Justin, Kyriakidis Konstatinos, Elizabeth Dean, Mathew Farthing
Department of Vascular Surgery, Colchester University Hospital, Colchester, Essex, UK; Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Department of Vascular Surgery, Colchester University Hospital, Colchester, Essex, UK.
Ann Vasc Surg. 2019 Nov;61:278-283. doi: 10.1016/j.avsg.2019.04.019. Epub 2019 Jul 20.
The aim of the study is to determine whether performing endovascular aortic aneurysm repair (EVAR) in a dedicated vascular hybrid operating room (OR) is associated with a decreased patient radiation and contrast dose compared with mobile C-arm imaging in a conventional OR.
This is a retrospective study of patients undergoing standard EVAR from 2009-2016. "Standard EVAR" was defined as the elective EVAR performed with bifurcated graft for infrarenal aneurysm with no iliac aneurysms. Patients were divided into 2 groups. Group 1 included EVARs performed in conventional theater with a mobile C-arm (January 2009 to June 2012) and group 2 EVARs performed in the dedicated vascular hybrid OR (July 2012 to December 2016). Data collected included patient demographics, aneurysm diameter, neck length, radiation dose, screening time, and contrast use of each patient.
There were 286 patients, 78 and 208 patients in group 1 and 2, respectively. There was no difference in age (77.6 years [76.3-78.9] vs. 76.6 years [75.9-77.9], P > 0.05), body mass index (26.5 kg/m [25.1-28.0] vs. 27.9 kg/m [27.1-28.7] P > 0.05), and mean aneurysm diameter (6.48 cms [6.13-6.82] vs. 6.81 cms [6.0-7.7], P > 0.05) between groups. Patients in group 2 received approximately half the mean radiation dose (16,807 cGy cm [±11,078] vs. 8,233 cGy cm [±7,471], P < 0.001), shorter fluoroscopy time (36.02 min [±21.3] vs. 26.96 min [±19], P = 0.001), and less contrast use (114 mls [±44.2] vs. 158 mls [±63.9], P < 0.001).
Performing EVAR in a dedicated vascular Hybrid OR may be associated with a lower patient radiation dose, shorter screening time, and less contrast use than performing EVAR in a conventional OR.
本研究的目的是确定在专用血管杂交手术室（OR）中进行血管内主动脉瘤修复术（EVAR）与在传统手术室中使用移动C形臂成像相比，是否能降低患者的辐射剂量和造影剂用量。
这是一项对2009年至2016年接受标准EVAR治疗患者的回顾性研究。“标准EVAR”定义为使用分叉移植物对无髂动脉瘤的肾下动脉瘤进行的择期EVAR。患者分为两组。第1组包括在传统手术室使用移动C形臂进行的EVAR（2009年1月至2012年6月），第2组包括在专用血管杂交手术室进行的EVAR（2012年7月至2016年12月）。收集的数据包括患者人口统计学信息、动脉瘤直径、颈部长度、辐射剂量、筛查时间以及每位患者的造影剂使用情况。
共有286例患者，第1组和第2组分别有78例和208例患者。两组患者在年龄（77.6岁[76.3 - 78.9] vs. 76.6岁[75.9 - 77.9]，P > 0.05）、体重指数（26.5 kg/m[25.1 - 28.0] vs. 27.9 kg/m[27.1 - 28.7]，P > 0.05）以及平均动脉瘤直径（6.48 cm[6.13 - 6.82] vs. 6.81 cm[6.0 - 7.7]，P > 0.05）方面无差异。第2组患者接受的平均辐射剂量约为第1组的一半（16,807 cGy cm[±11,078] vs. 8,233 cGy cm[±7,471]，P < 0.001），透视时间更短（36.02分钟[±21.3] vs. 26.96分钟[±19]，P = 0.001），造影剂用量更少（114 ml[±44.2] vs. 158 ml[±63.9]，P < 0.001）。
与在传统手术室中进行EVAR相比，在专用血管杂交手术室中进行EVAR可能使患者辐射剂量更低、筛查时间更短且造影剂用量更少。
