Radiation Dosage for Percutaneous PAD Treatment is Different in Cardiovascular Disciplines: Results From an Eleven Year Population Based Registry in the Metropolitan Area of Hamburg
Standard
Radiation Dosage for Percutaneous PAD Treatment is Different in Cardiovascular Disciplines: Results From an Eleven Year Population Based Registry in the Metropolitan Area of Hamburg. / Behrendt, C-A; Rieß, H C; Heidemann, F; Diener, H; Rohlffs, F; Hohnhold, R; Debus, E S.
In: EUR J VASC ENDOVASC, Vol. 53, No. 2, 02.2017, p. 215-222.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Radiation Dosage for Percutaneous PAD Treatment is Different in Cardiovascular Disciplines: Results From an Eleven Year Population Based Registry in the Metropolitan Area of Hamburg
AU - Behrendt, C-A
AU - Rieß, H C
AU - Heidemann, F
AU - Diener, H
AU - Rohlffs, F
AU - Hohnhold, R
AU - Debus, E S
N1 - Copyright © 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
PY - 2017/2
Y1 - 2017/2
N2 - OBJECTIVE: The worldwide prevalence of peripheral artery disease (PAD) has evolved to an intervention as the primary treatment option and therefore radiation is used with escalating incidence. Dose area product (DAP) correlates well with the total energy imparted to the patient during fluoroscopic interventions. This study aims to determine whether there are any associations among stage of disease, gender, age, and expertise on the radiation dose in single endovascular treatments of PAD.METHODS: This study was a prospective, mandatory, population based cross-sectional registry design. In total, 24,000 invasive percutaneous endovascular treatments of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2015. DAP was analysed by discipline conducting the procedure, Fontaine classification, patient gender, and age.RESULTS: Statistically significant differences in median DAP values were found. The lowest median DAP values were observed in surgical centres (7.1 vs. 18.0 Gy*cm2, p<.001) and in endovascular revascularisations (ER) following multidisciplinary consultation (11.6 vs. 23.4 Gy*cm2, p<.001). Considering the treatment of intermittent claudication, men had statistically significantly higher DAP values compared with women. Furthermore, lower median DAP values were observed in higher age groups, with lowest dosages in octogenarians.CONCLUSION: This is the first large population based study on DAP during ER for PAD. Several significant differences in median DAP values were observed, although patient stratification was comparable. Pre-operative therapy strategy planning can lead to lower DAP values, emphasising the importance of further vascular research and quality improvement projects targeting this topic. To date, available evidence is limited and therefore there is no accepted range of DAP levels. However, the ever increasing use of fluoroscopic interventions means that further investigation into radiation exposure to patients and healthcare professionals is required in order to keep DAP levels low.
AB - OBJECTIVE: The worldwide prevalence of peripheral artery disease (PAD) has evolved to an intervention as the primary treatment option and therefore radiation is used with escalating incidence. Dose area product (DAP) correlates well with the total energy imparted to the patient during fluoroscopic interventions. This study aims to determine whether there are any associations among stage of disease, gender, age, and expertise on the radiation dose in single endovascular treatments of PAD.METHODS: This study was a prospective, mandatory, population based cross-sectional registry design. In total, 24,000 invasive percutaneous endovascular treatments of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2015. DAP was analysed by discipline conducting the procedure, Fontaine classification, patient gender, and age.RESULTS: Statistically significant differences in median DAP values were found. The lowest median DAP values were observed in surgical centres (7.1 vs. 18.0 Gy*cm2, p<.001) and in endovascular revascularisations (ER) following multidisciplinary consultation (11.6 vs. 23.4 Gy*cm2, p<.001). Considering the treatment of intermittent claudication, men had statistically significantly higher DAP values compared with women. Furthermore, lower median DAP values were observed in higher age groups, with lowest dosages in octogenarians.CONCLUSION: This is the first large population based study on DAP during ER for PAD. Several significant differences in median DAP values were observed, although patient stratification was comparable. Pre-operative therapy strategy planning can lead to lower DAP values, emphasising the importance of further vascular research and quality improvement projects targeting this topic. To date, available evidence is limited and therefore there is no accepted range of DAP levels. However, the ever increasing use of fluoroscopic interventions means that further investigation into radiation exposure to patients and healthcare professionals is required in order to keep DAP levels low.
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Critical Illness
KW - Cross-Sectional Studies
KW - Endovascular Procedures/adverse effects
KW - Female
KW - Germany
KW - Humans
KW - Intermittent Claudication/diagnostic imaging
KW - Ischemia/diagnosis
KW - Male
KW - Middle Aged
KW - Peripheral Arterial Disease/diagnostic imaging
KW - Practice Patterns, Physicians'
KW - Prospective Studies
KW - Radiation Dosage
KW - Radiation Exposure/adverse effects
KW - Radiography, Interventional/adverse effects
KW - Registries
KW - Risk Factors
KW - Sex Factors
KW - Specialization
KW - Treatment Outcome
U2 - 10.1016/j.ejvs.2016.11.001
DO - 10.1016/j.ejvs.2016.11.001
M3 - SCORING: Journal article
C2 - 27974252
VL - 53
SP - 215
EP - 222
JO - EUR J VASC ENDOVASC
JF - EUR J VASC ENDOVASC
SN - 1078-5884
IS - 2
ER -