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A Phantom Menace to Medical Personnel During Endovascular Treatment of Cerebral Aneurysms: Real-Time Measurement of Radiation Exposure During Procedures.

World Neurosurgery 2019 January 25
BACKGROUND: The number of endovascular treatment procedures performed for cerebral aneurysms has markedly increased. However, little is known about the annual effective radiation dose to medical staff in neurointervention fields. We performed a retrospective observational study to investigate the real-time radiation dose to surgeons, nurses, anesthesiologists, and radiologic technologists during endovascular treatment for intracranial aneurysms.

METHODS: We measured real-time radiation doses for 2 weeks under standard and reinforced protection, during which 28 procedures were performed, including 23 coil embolizations for unruptured intracranial aneurysms. Four procedures were excluded due to an inadequately equipped sensor causing inappropriate data collection. Procedure time was defined as intubation to extubation. Five RaySafe i2 detectors were installed at the chest level of the operator, attending nurse, radiologic technologist, and anesthesiologist and just inside the front door of the hybrid operating room, respectively.

RESULTS: The median doses per session under standard protection to the operator, attending nurse, anesthesiologist, and radiologic technologist were 11.16, 2.60, 4.76, and 1.93 μSv, respectively. Those to the operator, attending nurse, and anesthesiologist decreased to 6.63, 0.39, and 1.52 μSv under reinforced protection, respectively. However, the session dose for the radiologic technologist increased to 3.12 μSv.

CONCLUSIONS: We confirmed differences in the amount of radiation exposure for different roles. An additional lead screen that provided more effective protection on the operator side was proven to be effective for attenuating radiation exposure during endovascular treatment. All personnel involved in the hybrid operating room were exposed to acceptable effective doses.

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