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

Abstract

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 neuro-intervention fields. We performed a retrospective observational study to investigate the real-time radiation dose to surgeons, nurses, anesthesiologists, and radiologic technologists during endovascular treatment of intracranial aneurysms.,METHODS: We measured the real-time radiation doses for 2 weeks using standard and reinforced protection, during which 28 procedures were performed, including 23 coil embolizations for unruptured intracranial aneurysms. Four procedures were excluded because of an inadequately equipped sensor, which resulted in inappropriate data collection. The procedure time was defined from 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.,RESULTS: The median doses per session with standard protection to the operator, attending nurse, anesthesiologist, and radiologic technologist were 11.16, 2.60, 4.76, and 1.93 mu Sv, respectively. The dose to the operator, attending nurse, and anesthesiologist had decreased to 6.63, 0.39, and 1.52 mu Sv under reinforced protection, respectively. However, the session dose for the radiologic technologist had increased to 3.12 mu Sv.,CONCLUSIONS: We confirmed the differences in the amount of radiation exposure for different roles. An additional lead screen, which provided more effective protection on the operator side, was proved effective for attenuating radiation exposure during endovascular treatment. All personnel involved in the hybrid operating room were exposed to acceptable effective doses.