Haga Yoshihiro, Chida Koichi, Sota Masahiro, Kaga Yuji, Abe Mitsuya, Inaba Yohei, Suzuki Masatoshi, Meguro Taiichiro, Zuguchi Masayuki
Course of Radiological Technology, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo, Aoba, Sendai, Miyagi 980-8575, Japan.
Department of Radiology, Sendai Kousei Hospital, 4-15 Hirosemachi, Aoba, Sendai 980-0873, Japan.
Diagnostics (Basel). 2020 Oct 19;10(10):846. doi: 10.3390/diagnostics10100846.
In recent years, endovascular treatment of aortic aneurysms has attracted considerable attention as a promising alternative to traditional surgery. Hybrid operating room systems (HORSs) are increasingly being used to perform endovascular procedures. The clinical benefits of endovascular treatments using HORSs are very clear, and these procedures are increasing in number. In procedures such as thoracic endovascular aortic repair (TEVAR) and endovascular aortic repair (EVAR), wires and catheters are used to deliver and deploy the stent graft in the thoracic/abdominal aorta under fluoroscopic control, including DSA. Thus, the radiation dose to the patient is an important issue. We determined radiation dose indicators (the dose-area product (DAP) and air karma (AK) parameters) associated with endovascular treatments (EVAR and TEVAR) using a HORS. As a result, the mean ± standard deviation (SD) DAPs of TEVAR and EVAR were 323.7 ± 161.0 and 371.3 ± 186.0 Gy x cm, respectively. The mean ± SD AKs of TEVAR and EVAR were 0.92 ± 0.44 and 1.11 ± 0.54 Gy, respectively. The mean ± SD fluoroscopy times of TEVAR and EVAR were 13.4 ± 7.1 and 23.2 ± 11.7 min, respectively. Patient radiation dose results in this study of endovascular treatments using HORSs showed no deterministic radiation effects, such as skin injuries. However, radiation exposure during TEVAR and EVAR cannot be ignored. The radiation dose should be evaluated in HORSs during endovascular treatments. Reducing/optimizing the radiation dose to the patient in HORSs is important.
近年来，作为传统手术的一种有前景的替代方法，主动脉瘤的血管内治疗引起了广泛关注。混合手术室系统（HORSs）越来越多地用于进行血管内手术。使用HORSs进行血管内治疗的临床益处非常明显，并且此类手术的数量正在增加。在诸如胸主动脉腔内修复术（TEVAR）和腹主动脉腔内修复术（EVAR）等手术中，导线和导管用于在荧光透视控制（包括数字减影血管造影术（DSA））下将支架移植物输送并部署到胸/腹主动脉中。因此，患者所接受的辐射剂量是一个重要问题。我们确定了与使用HORS进行血管内治疗（EVAR和TEVAR）相关的辐射剂量指标（剂量面积乘积（DAP）和空气比释动能（AK）参数）。结果，TEVAR和EVAR的平均±标准差（SD）DAP分别为323.7±161.0和371.3±186.0 Gy×cm。TEVAR和EVAR的平均±SD AK分别为0.92±0.44和1.11±0.54 Gy。TEVAR和EVAR的平均±SD透视时间分别为13.4±7.1和23.2±11.7分钟。本研究中使用HORS进行血管内治疗的患者辐射剂量结果显示没有确定性的辐射效应，如皮肤损伤。然而，TEVAR和EVAR期间的辐射暴露不能被忽视。在血管内治疗期间，应在HORS中评估辐射剂量。在HORS中降低/优化患者的辐射剂量很重要。
