Radiation dose and risk from fluoroscopically guided percutaneous transluminal angioplasty and stenting in the abdominal region

The objective of this study was to estimate the radiation dose and associated risks resulting from fluoroscopically guided percutaneous transluminal angioplasty with or without stent placement in the abdominal region. Average examination parameters for renal and aortoiliac procedures were derived using data from 80 consecutive procedures performed in our institute. Organ and effective doses were estimated for endovascular procedures with the use of a Monte Carlo (MC) transport code and an adult mathematical phantom. Thermoluminescent dosimeters were used in an anthropomorphic phantom to verify MC calculations. Radiation-induced risks were estimated. Results are presented as doses normalized to dose area product, so that the patient dose from any technique and X-ray unit can be easily calculated for iliac and renal PTA/stenting sessions. The average effective dose varied from 75 to 371 μSv per Gycm2 depending on the beam quality, procedure scheme and sex of the patient. Differences up to 17% were observed between MC-calculated data and data derived from thermoluminescent dosimetry. The radiation-induced cancer risk may be considerable for younger individuals undergoing transluminal angioplasty with stent placement. (orig.)