Estimation of patient doses and cancer risk to patients during EVAR procedures

Purpose Endovascular aneurysm repair (EVAR) procedures are associated with high patient radiation doses. On the other hand, dosimetric data on EVAR procedures in literature is limited. The aims of this study were to estimate radiation dose and risk associated with typical EVAR procedures and provide normalized organ and effective dose data related to EVAR procedures. Methods Data from 28 consecutive patients who underwent EVAR procedures in a tertiary medical facility within an 18-month period were retrieved and analyzed for this study. Monte Carlo PCXMC 2.0.1.4 software was used for the patient dose estimation; analysis was done with Medcalc statistical package and then Microsoft Excel was used for the cancer risks. Results Mean Dose Area Product (DAP) for fluoroscopy was 132.96 Gy<middle dot>cm(2) and that for digital subtraction angiography was 100.46 Gy<middle dot>cm(2). The study showed strong correlation between total fluoroscopy time and total cumulative dose (r = 0.904, P < 0.0001). Estimated organ and effective dose conversion coefficients for EVAR procedure were 0.131 mGy/Gy<middle dot>cm(2) and 0.114 mSv/Gy<middle dot>cm(2) respectively. The highest cancer mortality risk was estimated as 342 per 100,000 cases for all cancers among age group < 60 years and least mortality risk was estimated as 5.7 per 100,000 cases for ages 70 years and above. Conclusions The study has estimated radiation dose and risk associated with typical EVAR procedures and determined normalized organ and effective doses. The dosimetric data was comparable with other studies reported. The dose conversion coefficient for organ and effective doses determined in this study may be used considering the procedure conditions from the study.