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Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age

PURPOSE: Endovascular treatment of unruptured intracranial aneurysms (UIAs) requires a risk–benefit analysis and adherence to diagnostic reference levels (DRLs). The national DRL (250 Gy·cm(2)) is only determined for intracranial aneurysm coiling in general, including ruptured intracranial aneurysms...

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Autores principales: Opitz, Marcel, Zenk, Celina, Zensen, Sebastian, Bos, Denise, Li, Yan, Styczen, Hanna, Oppong, Marvin Darkwah, Jabbarli, Ramazan, Hagenacker, Tim, Forsting, Michael, Wanke, Isabel, Deuschl, Cornelius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905176/
https://www.ncbi.nlm.nih.gov/pubmed/36418556
http://dx.doi.org/10.1007/s00234-022-03092-8
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author Opitz, Marcel
Zenk, Celina
Zensen, Sebastian
Bos, Denise
Li, Yan
Styczen, Hanna
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Hagenacker, Tim
Forsting, Michael
Wanke, Isabel
Deuschl, Cornelius
author_facet Opitz, Marcel
Zenk, Celina
Zensen, Sebastian
Bos, Denise
Li, Yan
Styczen, Hanna
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Hagenacker, Tim
Forsting, Michael
Wanke, Isabel
Deuschl, Cornelius
author_sort Opitz, Marcel
collection PubMed
description PURPOSE: Endovascular treatment of unruptured intracranial aneurysms (UIAs) requires a risk–benefit analysis and adherence to diagnostic reference levels (DRLs). The national DRL (250 Gy·cm(2)) is only determined for intracranial aneurysm coiling in general, including ruptured intracranial aneurysms (RIAs). This study aims to investigate the dose in the treatment of UIAs and RIAs separately. METHODS: In a retrospective study design, dose area product (DAP) and fluoroscopy time (FT) were assessed for all patients undergoing intracranial aneurysm coiling between 2010 and 2021. DRL was set as the 75th percentile of the dose distribution. A multivariable linear regression analysis was performed to investigate DAP and FT for the two groups, UIA and RIA adjusted for patient age, aneurysm size, and location. RESULTS: 583 (414 females, mean age 56.5 years, 311 UIAs) are included. In the overall population, DAP (median (IQR)) is 157 Gy·cm(2) (108–217) with a median FT of 32.7 min (IQR 24.0–47.0). Local DRL is 183 Gy·cm(2) for UIAs and 246 Gy·cm(2) for RIAs. After adjustment for the other variables, the UIA and RIA groups have a significant effect on both DAP (p < 0.001; 95% CI − 68.432 – − 38.040) and FT (p < 0.001; 95% CI − 628.279 – − 291.254). In general, both DAP and FT increase significantly with patient age and aneurysm size, whereas the location of the aneurysm did not significantly change neither DAP (p = 0.171; 95% CI − 5.537–31.065) nor FT (p = 0.136; 95% CI − 357.391–48.508). CONCLUSION: Both aneurysm size and patient age were associated with increased DAP, whereas aneurysm location did not significantly change DAP or FT. The increased dose in patients with RIAs is likely equivalent to additional diagnostic cerebral four-vessel angiography performed in this group.
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spelling pubmed-99051762023-02-08 Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age Opitz, Marcel Zenk, Celina Zensen, Sebastian Bos, Denise Li, Yan Styczen, Hanna Oppong, Marvin Darkwah Jabbarli, Ramazan Hagenacker, Tim Forsting, Michael Wanke, Isabel Deuschl, Cornelius Neuroradiology Interventional Neuroradiology PURPOSE: Endovascular treatment of unruptured intracranial aneurysms (UIAs) requires a risk–benefit analysis and adherence to diagnostic reference levels (DRLs). The national DRL (250 Gy·cm(2)) is only determined for intracranial aneurysm coiling in general, including ruptured intracranial aneurysms (RIAs). This study aims to investigate the dose in the treatment of UIAs and RIAs separately. METHODS: In a retrospective study design, dose area product (DAP) and fluoroscopy time (FT) were assessed for all patients undergoing intracranial aneurysm coiling between 2010 and 2021. DRL was set as the 75th percentile of the dose distribution. A multivariable linear regression analysis was performed to investigate DAP and FT for the two groups, UIA and RIA adjusted for patient age, aneurysm size, and location. RESULTS: 583 (414 females, mean age 56.5 years, 311 UIAs) are included. In the overall population, DAP (median (IQR)) is 157 Gy·cm(2) (108–217) with a median FT of 32.7 min (IQR 24.0–47.0). Local DRL is 183 Gy·cm(2) for UIAs and 246 Gy·cm(2) for RIAs. After adjustment for the other variables, the UIA and RIA groups have a significant effect on both DAP (p < 0.001; 95% CI − 68.432 – − 38.040) and FT (p < 0.001; 95% CI − 628.279 – − 291.254). In general, both DAP and FT increase significantly with patient age and aneurysm size, whereas the location of the aneurysm did not significantly change neither DAP (p = 0.171; 95% CI − 5.537–31.065) nor FT (p = 0.136; 95% CI − 357.391–48.508). CONCLUSION: Both aneurysm size and patient age were associated with increased DAP, whereas aneurysm location did not significantly change DAP or FT. The increased dose in patients with RIAs is likely equivalent to additional diagnostic cerebral four-vessel angiography performed in this group. Springer Berlin Heidelberg 2022-11-22 2023 /pmc/articles/PMC9905176/ /pubmed/36418556 http://dx.doi.org/10.1007/s00234-022-03092-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Interventional Neuroradiology
Opitz, Marcel
Zenk, Celina
Zensen, Sebastian
Bos, Denise
Li, Yan
Styczen, Hanna
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Hagenacker, Tim
Forsting, Michael
Wanke, Isabel
Deuschl, Cornelius
Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title_full Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title_fullStr Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title_full_unstemmed Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title_short Radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
title_sort radiation dose and fluoroscopy time of aneurysm coiling in patients with unruptured and ruptured intracranial aneurysms as a function of aneurysm size, location, and patient age
topic Interventional Neuroradiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9905176/
https://www.ncbi.nlm.nih.gov/pubmed/36418556
http://dx.doi.org/10.1007/s00234-022-03092-8
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