Endovascular Aneurysm Repair (EVAR) has become the treatment of choice for patients with abdominal aortic aneurysms with suitable anatomy[1]. The EVAR-1 trial[2] showed that EVAR has a reduced short term mortality compared with open repair, as well as reduced morbidity[3,4]. However, concerns exist regarding the radiation exposure during fluoroscopically based interventional procedures[5,6]. EVAR procedures have become increasingly complex and are therefore associated with an increased radiation burden[7]. Diagnostic Reference Levels (DRLs) have been introduced in clinical practice as a tool for monitoring patient radiation dose...

Institutional permission to collate data was attained from each clinical centre. Retrospective dose data was collected for 180 standard EVARs performed between January 2014 – July 2015 from five specialist centres in Ireland (n =2) and Italy (n=3). Standard non-fenestrated EVAR procedures only were included. Centres offering specialised services to regions of similar size were included and who had experience performing EVAR of over a decade. Patient BMI and gender demographics were reviewed. Collected data included: PKA/DAP- kerma-area product/dose area product Ka,r - total air...

Data was analysed for individual centres and grouped to facilitate overall data review. The histogram (Figure 4) displays the overall PKA distribution. As with most radiation dose data, results were not normally distributed. Table 1 displays a summary of results for each centre (A,B,C,D and E). An overall 75th percentile dose Reference Level for all centres was established as 15849 μGym2. Total air kerma at the reference point (Ka,r) was also gathered for each procedure and is an estimation of the maximum potential skin dose...

Abdominal Aortic Endovascular Aneurysm Repair is an increasingly common procedure and the radiation burden associated with it cannot be ignored. In compliance with European Directive 2013/59/EURATOM this study aimed to increase the evidence base for abdominal aortic EVAR procedure reference levels and proposes an interim DRL of 15849 µGym2.

1 School of Medicine, University College Dublin, Ireland; 2 Diagnostic Imaging, Mater Misericordiae University Hospital, Dublin, Ireland;3Diagnostic Imaging, San Giovanni di Dio Hospital, Florence, Italy; 4Diagnostic Imaging, Mater Private Hospital, Dublin, Ireland; 5 Diagnostic Imaging, Mauriziano- Umberto Hospital, Turin, Italy; 6 Diagnostic Imaging, Policlinico S.Orsola-Malpighi, Bologna, Italy; 7 AITRI, Association of Italian Interventional Radiographers, Milan, Italy.

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