Radiation exposure during angiographic interventions in interventional radiology – risk and fate of advanced procedures

Abstract

Purpose

Advanced angiographic procedures in interventional radiology are becoming more important and are more frequently used, especially in the treatment of several acute life-threatening diseases like stroke or aortic injury. In recent years, technical advancement has led to a broader spectrum of interventions and complex procedures with longer fluoroscopy times. This involves the risk of higher dose exposures, which, in rare cases, may cause deterministic radiation effects, e.g. erythema in patients undergoing angiographic procedures. Against this background, these procedures recently also became subject to national and international regulations regarding radiation protection. At the same time, individual risk assessment of possible stochastic radiation effects for each patient must be weighed up against the anticipated benefits of the therapy itself. Harmful effects of the administered dose are not limited to the patient but can also affect the radiologist and the medical staff. In particular, the development of cataracts in interventionalists is a rising matter of concern. Furthermore, long-term effects of repeated and prolonged x-ray exposure have long been neglected by radiologists but have come into focus in the past years.

Conclusions

With all this in mind, this review discusses different efforts to reduce radiation exposition levels for patients and medical staff by means of technical, personal as well as organizational measures.

Keywords:

• Interventional radiology
• radiation protection
• fluoroscopy
• dose reduction

Disclosure statement

All authors declare no conflict of interest.

Additional information

Notes on contributors

Hanns Leonhard Kaatsch

Hanns Leonhard Kaatsch, MD, is a resident in Radiology and a Post-Doctoral Researcher of Radiobiology at the Bundeswehr Institute of Radiobiology, Munich, Germany.

Julian Schneider

Julian Schneider, MD, is a Consultant Radiologist at the Bundeswehr Central Hospital, Koblenz, Germany.

Carolin Brockmann

Carolin Brockmann, MD, is a Professor of Neuroradiology and Consultant Radiologist as well as Neuroradiologist at the University Medical Center Mainz, Germany.

Marc A. Brockmann

Marc A. Brockmann, MD, M.Sc., is a Full Professor of Neuroradiology and Chair of Department of Neuroradiology at the University Medical Center Mainz, Germany.

Daniel Overhoff

Daniel Overhoff, MD, is a Consultant Radiologist at the Bundeswehr Central Hospital, Koblenz, Germany.

Benjamin Valentin Becker

Benjamin Valentin Becker, MD, is a Consultant Radiologist at the Bundeswehr Central Hospital Koblenz, Germany.

Stephan Waldeck

Stephan Waldeck, MD, is a Consultant Radiologist und Neuroradiologist and Head of Department of Radiology and Neuroradiology at the Bundeswehr Central Hospital, Koblenz, Germany.