Patient radiation exposure for endovascular deep venous interventions
The study aimed to assess the cumulative radiation exposure from preoperative, periprocedural, and follow-up imaging to patients who underwent common endovascular deep venous interventions for acute and chronic central venous outflow obstructive diseases; namely, deep vein thrombosis (DVT) thromboly...
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Veröffentlicht in: | Journal of vascular surgery. Venous and lymphatic disorders (New York, NY) NY), 2020-03, Vol.8 (2), p.259-267 |
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creator | Lim, Chung Sim Waseem, Saima El-Sayed, Tamer Budge, James Quintana, Belen Thulasidasan, Narayanan Karunanithy, Narayan Black, Stephen A. |
description | The study aimed to assess the cumulative radiation exposure from preoperative, periprocedural, and follow-up imaging to patients who underwent common endovascular deep venous interventions for acute and chronic central venous outflow obstructive diseases; namely, deep vein thrombosis (DVT) thrombolysis, unilateral chronic iliofemoral venous stenting, and inferior vena cava (IVC) reconstruction in a single center.
Patients who had DVT thrombolysis of upper extremity (UE) DVT and lower extremity (LE) DVT, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction between May 1, 2012, and July 31, 2017, in a single unit were retrospectively reviewed. Demographic data, anatomic DVT, imaging, technical details of the index procedure, follow-up, and radiation exposure measured in dose-length product, dose-area product (DAP), and fluoroscopy time (FT) from related computed tomography scans and interventions were analyzed. Mann-Whitney U tests were performed to assess for significance of differences between subgroups. A P value of less than .05 was considered significant.
In total, 20 UE DVT thrombolysis, 91 LE DVT thrombolysis, 56 unilateral chronic iliofemoral venous stenting, and 39 endovascular IVC reconstruction patients were included in the study, with the following median ages: 39 years (range, 20-67 years), 44 years (range, 15-78 years), 45 years (range, 20-80 years), and 35 years (range, 18 -73 years), respectively. The median cumulative DAP for the index DVT thrombolysis was 9.2 Gycm2 (range, 0.2-176.0 Gycm2) for LE DVT and 2.0 Gycm2 (range, 0.1-11.7 Gycm2) for UE DVT (P < .0001). The median cumulative FT for the index thrombolysis was 981 seconds (range, 20-4890 seconds) and 837 seconds (range, 19-2895 seconds) for LE DVT and UE DVT, respectively (P = .18). For unilateral chronic iliofemoral venous stenting, the median cumulative DAP and FT were 32.4 Gycm2 (range, 0.1-289.6 Gycm2) and 660 seconds (range, 246-4200 seconds), respectively. Meanwhile, the median cumulative DAP and FT for the endovascular IVC reconstruction were 60.8 Gycm2 (range, 2.5-269.1 Gycm2) and 2846 seconds (range, 836-11682 seconds), respectively. The median DAP for secondary procedures during follow-up was 6.6 Gycm2 (range, 0.8 186.5 Gycm2), 1.9 Gycm2 (range, 0.2-111.7 Gycm2), and 24.3 Gycm2 (range, 0.2-157.5 Gycm2) for LE DVT thrombolysis, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction, respectively.
Patient radiation ex |
doi_str_mv | 10.1016/j.jvsv.2019.03.018 |
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Patients who had DVT thrombolysis of upper extremity (UE) DVT and lower extremity (LE) DVT, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction between May 1, 2012, and July 31, 2017, in a single unit were retrospectively reviewed. Demographic data, anatomic DVT, imaging, technical details of the index procedure, follow-up, and radiation exposure measured in dose-length product, dose-area product (DAP), and fluoroscopy time (FT) from related computed tomography scans and interventions were analyzed. Mann-Whitney U tests were performed to assess for significance of differences between subgroups. A P value of less than .05 was considered significant.
In total, 20 UE DVT thrombolysis, 91 LE DVT thrombolysis, 56 unilateral chronic iliofemoral venous stenting, and 39 endovascular IVC reconstruction patients were included in the study, with the following median ages: 39 years (range, 20-67 years), 44 years (range, 15-78 years), 45 years (range, 20-80 years), and 35 years (range, 18 -73 years), respectively. The median cumulative DAP for the index DVT thrombolysis was 9.2 Gycm2 (range, 0.2-176.0 Gycm2) for LE DVT and 2.0 Gycm2 (range, 0.1-11.7 Gycm2) for UE DVT (P < .0001). The median cumulative FT for the index thrombolysis was 981 seconds (range, 20-4890 seconds) and 837 seconds (range, 19-2895 seconds) for LE DVT and UE DVT, respectively (P = .18). For unilateral chronic iliofemoral venous stenting, the median cumulative DAP and FT were 32.4 Gycm2 (range, 0.1-289.6 Gycm2) and 660 seconds (range, 246-4200 seconds), respectively. Meanwhile, the median cumulative DAP and FT for the endovascular IVC reconstruction were 60.8 Gycm2 (range, 2.5-269.1 Gycm2) and 2846 seconds (range, 836-11682 seconds), respectively. The median DAP for secondary procedures during follow-up was 6.6 Gycm2 (range, 0.8 186.5 Gycm2), 1.9 Gycm2 (range, 0.2-111.7 Gycm2), and 24.3 Gycm2 (range, 0.2-157.5 Gycm2) for LE DVT thrombolysis, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction, respectively.
Patient radiation exposure for endovascular deep venous interventions for central venous outflow obstruction measured in DAP and FT seemed to be less than and at most similar to anatomically comparable arterial interventions in the literature. However, these patients were usually much younger than those with arterial diseases and may need secondary interventions involving further radiation exposure in their lifetime.
[Display omitted]</description><identifier>ISSN: 2213-333X</identifier><identifier>EISSN: 2213-3348</identifier><identifier>DOI: 10.1016/j.jvsv.2019.03.018</identifier><identifier>PMID: 31248834</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Deep vein thrombosis ; Ionizing radiation ; May-Thurner syndrome ; Post-thrombotic syndrome ; Thrombolysis ; Venous stent</subject><ispartof>Journal of vascular surgery. Venous and lymphatic disorders (New York, NY), 2020-03, Vol.8 (2), p.259-267</ispartof><rights>2019 Society for Vascular Surgery</rights><rights>Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-44e89821debcbff11da5c1eee0e68d83e20ff914e4eb22efabced04fb1e8d9553</citedby><cites>FETCH-LOGICAL-c400t-44e89821debcbff11da5c1eee0e68d83e20ff914e4eb22efabced04fb1e8d9553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31248834$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lim, Chung Sim</creatorcontrib><creatorcontrib>Waseem, Saima</creatorcontrib><creatorcontrib>El-Sayed, Tamer</creatorcontrib><creatorcontrib>Budge, James</creatorcontrib><creatorcontrib>Quintana, Belen</creatorcontrib><creatorcontrib>Thulasidasan, Narayanan</creatorcontrib><creatorcontrib>Karunanithy, Narayan</creatorcontrib><creatorcontrib>Black, Stephen A.</creatorcontrib><title>Patient radiation exposure for endovascular deep venous interventions</title><title>Journal of vascular surgery. Venous and lymphatic disorders (New York, NY)</title><addtitle>J Vasc Surg Venous Lymphat Disord</addtitle><description>The study aimed to assess the cumulative radiation exposure from preoperative, periprocedural, and follow-up imaging to patients who underwent common endovascular deep venous interventions for acute and chronic central venous outflow obstructive diseases; namely, deep vein thrombosis (DVT) thrombolysis, unilateral chronic iliofemoral venous stenting, and inferior vena cava (IVC) reconstruction in a single center.
Patients who had DVT thrombolysis of upper extremity (UE) DVT and lower extremity (LE) DVT, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction between May 1, 2012, and July 31, 2017, in a single unit were retrospectively reviewed. Demographic data, anatomic DVT, imaging, technical details of the index procedure, follow-up, and radiation exposure measured in dose-length product, dose-area product (DAP), and fluoroscopy time (FT) from related computed tomography scans and interventions were analyzed. Mann-Whitney U tests were performed to assess for significance of differences between subgroups. A P value of less than .05 was considered significant.
In total, 20 UE DVT thrombolysis, 91 LE DVT thrombolysis, 56 unilateral chronic iliofemoral venous stenting, and 39 endovascular IVC reconstruction patients were included in the study, with the following median ages: 39 years (range, 20-67 years), 44 years (range, 15-78 years), 45 years (range, 20-80 years), and 35 years (range, 18 -73 years), respectively. The median cumulative DAP for the index DVT thrombolysis was 9.2 Gycm2 (range, 0.2-176.0 Gycm2) for LE DVT and 2.0 Gycm2 (range, 0.1-11.7 Gycm2) for UE DVT (P < .0001). The median cumulative FT for the index thrombolysis was 981 seconds (range, 20-4890 seconds) and 837 seconds (range, 19-2895 seconds) for LE DVT and UE DVT, respectively (P = .18). For unilateral chronic iliofemoral venous stenting, the median cumulative DAP and FT were 32.4 Gycm2 (range, 0.1-289.6 Gycm2) and 660 seconds (range, 246-4200 seconds), respectively. Meanwhile, the median cumulative DAP and FT for the endovascular IVC reconstruction were 60.8 Gycm2 (range, 2.5-269.1 Gycm2) and 2846 seconds (range, 836-11682 seconds), respectively. The median DAP for secondary procedures during follow-up was 6.6 Gycm2 (range, 0.8 186.5 Gycm2), 1.9 Gycm2 (range, 0.2-111.7 Gycm2), and 24.3 Gycm2 (range, 0.2-157.5 Gycm2) for LE DVT thrombolysis, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction, respectively.
Patient radiation exposure for endovascular deep venous interventions for central venous outflow obstruction measured in DAP and FT seemed to be less than and at most similar to anatomically comparable arterial interventions in the literature. However, these patients were usually much younger than those with arterial diseases and may need secondary interventions involving further radiation exposure in their lifetime.
[Display omitted]</description><subject>Deep vein thrombosis</subject><subject>Ionizing radiation</subject><subject>May-Thurner syndrome</subject><subject>Post-thrombotic syndrome</subject><subject>Thrombolysis</subject><subject>Venous stent</subject><issn>2213-333X</issn><issn>2213-3348</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLw0AUhQdRbKn9Ay4kSzeJ80o6ATdS6gMKulBwN0xm7kBCmqkzSdB_74TWLr2bexbnHO79ELomOCOYFHdN1oxhzCgmZYZZhok4Q3NKCUsZ4-L8pNnnDC1DaHAcURT5Cl-iGSOUC8H4HG3eVF9D1ydemTpK1yXwvXdh8JBY5xPojBtV0EOrfGIA9skInRtCUnc9-KinSLhCF1a1AZbHvUAfj5v39XO6fX16WT9sU80x7lPOQZSCEgOVrqwlxKhcEwDAUAgjGFBsbUk4cKgoBasqDQZzWxEQpsxztkC3h969d18DhF7u6qChbVUH8ShJaY4LXOYrEa30YNXeheDByr2vd8r_SILlRFA2ciIoJ4ISMxkJxtDNsX-odmBOkT9e0XB_MED8cqzBy6Ajvnhm7UH30rj6v_5fUICEfw</recordid><startdate>202003</startdate><enddate>202003</enddate><creator>Lim, Chung Sim</creator><creator>Waseem, Saima</creator><creator>El-Sayed, Tamer</creator><creator>Budge, James</creator><creator>Quintana, Belen</creator><creator>Thulasidasan, Narayanan</creator><creator>Karunanithy, Narayan</creator><creator>Black, Stephen A.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202003</creationdate><title>Patient radiation exposure for endovascular deep venous interventions</title><author>Lim, Chung Sim ; Waseem, Saima ; El-Sayed, Tamer ; Budge, James ; Quintana, Belen ; Thulasidasan, Narayanan ; Karunanithy, Narayan ; Black, Stephen A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-44e89821debcbff11da5c1eee0e68d83e20ff914e4eb22efabced04fb1e8d9553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Deep vein thrombosis</topic><topic>Ionizing radiation</topic><topic>May-Thurner syndrome</topic><topic>Post-thrombotic syndrome</topic><topic>Thrombolysis</topic><topic>Venous stent</topic><toplevel>online_resources</toplevel><creatorcontrib>Lim, Chung Sim</creatorcontrib><creatorcontrib>Waseem, Saima</creatorcontrib><creatorcontrib>El-Sayed, Tamer</creatorcontrib><creatorcontrib>Budge, James</creatorcontrib><creatorcontrib>Quintana, Belen</creatorcontrib><creatorcontrib>Thulasidasan, Narayanan</creatorcontrib><creatorcontrib>Karunanithy, Narayan</creatorcontrib><creatorcontrib>Black, Stephen A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery. Venous and lymphatic disorders (New York, NY)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lim, Chung Sim</au><au>Waseem, Saima</au><au>El-Sayed, Tamer</au><au>Budge, James</au><au>Quintana, Belen</au><au>Thulasidasan, Narayanan</au><au>Karunanithy, Narayan</au><au>Black, Stephen A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient radiation exposure for endovascular deep venous interventions</atitle><jtitle>Journal of vascular surgery. Venous and lymphatic disorders (New York, NY)</jtitle><addtitle>J Vasc Surg Venous Lymphat Disord</addtitle><date>2020-03</date><risdate>2020</risdate><volume>8</volume><issue>2</issue><spage>259</spage><epage>267</epage><pages>259-267</pages><issn>2213-333X</issn><eissn>2213-3348</eissn><abstract>The study aimed to assess the cumulative radiation exposure from preoperative, periprocedural, and follow-up imaging to patients who underwent common endovascular deep venous interventions for acute and chronic central venous outflow obstructive diseases; namely, deep vein thrombosis (DVT) thrombolysis, unilateral chronic iliofemoral venous stenting, and inferior vena cava (IVC) reconstruction in a single center.
Patients who had DVT thrombolysis of upper extremity (UE) DVT and lower extremity (LE) DVT, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction between May 1, 2012, and July 31, 2017, in a single unit were retrospectively reviewed. Demographic data, anatomic DVT, imaging, technical details of the index procedure, follow-up, and radiation exposure measured in dose-length product, dose-area product (DAP), and fluoroscopy time (FT) from related computed tomography scans and interventions were analyzed. Mann-Whitney U tests were performed to assess for significance of differences between subgroups. A P value of less than .05 was considered significant.
In total, 20 UE DVT thrombolysis, 91 LE DVT thrombolysis, 56 unilateral chronic iliofemoral venous stenting, and 39 endovascular IVC reconstruction patients were included in the study, with the following median ages: 39 years (range, 20-67 years), 44 years (range, 15-78 years), 45 years (range, 20-80 years), and 35 years (range, 18 -73 years), respectively. The median cumulative DAP for the index DVT thrombolysis was 9.2 Gycm2 (range, 0.2-176.0 Gycm2) for LE DVT and 2.0 Gycm2 (range, 0.1-11.7 Gycm2) for UE DVT (P < .0001). The median cumulative FT for the index thrombolysis was 981 seconds (range, 20-4890 seconds) and 837 seconds (range, 19-2895 seconds) for LE DVT and UE DVT, respectively (P = .18). For unilateral chronic iliofemoral venous stenting, the median cumulative DAP and FT were 32.4 Gycm2 (range, 0.1-289.6 Gycm2) and 660 seconds (range, 246-4200 seconds), respectively. Meanwhile, the median cumulative DAP and FT for the endovascular IVC reconstruction were 60.8 Gycm2 (range, 2.5-269.1 Gycm2) and 2846 seconds (range, 836-11682 seconds), respectively. The median DAP for secondary procedures during follow-up was 6.6 Gycm2 (range, 0.8 186.5 Gycm2), 1.9 Gycm2 (range, 0.2-111.7 Gycm2), and 24.3 Gycm2 (range, 0.2-157.5 Gycm2) for LE DVT thrombolysis, unilateral chronic iliofemoral venous stenting, and endovascular IVC reconstruction, respectively.
Patient radiation exposure for endovascular deep venous interventions for central venous outflow obstruction measured in DAP and FT seemed to be less than and at most similar to anatomically comparable arterial interventions in the literature. However, these patients were usually much younger than those with arterial diseases and may need secondary interventions involving further radiation exposure in their lifetime.
[Display omitted]</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31248834</pmid><doi>10.1016/j.jvsv.2019.03.018</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Deep vein thrombosis Ionizing radiation May-Thurner syndrome Post-thrombotic syndrome Thrombolysis Venous stent |
title | Patient radiation exposure for endovascular deep venous interventions |
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