Clinical audit comparing radiation dose metrics between WEB and coil embolisation in the treatment of intracranial aneurysms.

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dc.check.date2022-12-20
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorMurphy, Hazel
dc.contributor.authorScally, Andrew
dc.contributor.authorAndrew, Damon
dc.contributor.authorLord, James
dc.contributor.authorWyse, Gerald
dc.contributor.authorFanning, Noel
dc.contributor.authorYoung, Rena
dc.contributor.authorMoore, Niamh
dc.date.accessioned2022-03-02T13:01:15Z
dc.date.available2022-03-02T13:01:15Z
dc.date.issued2021-12-20
dc.date.updated2022-03-02T12:54:53Z
dc.description.abstractIntroduction: Intrasaccular flow disruption is a new and effective endovascular treatment for intracranial aneurysms. While endovascular treatment is a minimally invasive procedure, it does carry a radiation risk. As radiation dose should be kept as low as reasonably achievable (ALARA), the main objective of this study was to analyse KAP (kerma area product), fluoroscopy and procedure time during the treatment of aneurysms treated with coiling and the Woven-EndoBridge (WEB) device. A secondary objective was to look at the reference air kerma (RAK) to determine if the patient receives a dose that could cause tissue effects. Methods: KAP, fluoroscopy and procedure time were retrospectively analysed in patients who had an aneurysm treatment. Aneurysms with diameters of 4-11mm, over a four-year period, in the anterior and posterior circulation of the brain were analysed in this study. Patients were treated by coiling or WEB. RAK were summed together in the working projection to give an estimated entrance surface dose (ESD) in cases with the highest KAP. Results: A total of 47 aneurysms treated with WEB and 104 aneurysms treated with coiling techniques met the inclusion criteria. The average KAP was 6884.1 ± 2774.4μGym2 with coiling techniques and 5658.7 ± 1602.5μGym2 with WEB (p=0.006; CI =363-2086μGym2). This demonstrates an 18% reduction with WEB. Mean fluoroscopy time for coiling was 63.5 ± 42.6minutes and 33.8 ± 28.8minutes for WEB (p=<0.001; CI=16–43minutes). Fluoroscopy time was reduced by nearly 50% with WEB. On average, there was a 27-minute reduction of procedure time when using WEB compared to coiling. The RAK determined for the working projections did not exceed the 2Gy threshold for tissue effects. Conclusion: Treatment of aneurysms using the WEB shows a reduction in KAP, fluoroscopy, and procedure time. This study further demonstrates the benefits of intrasaccular flow disruption for treatment of intracranial aneurysms.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationMurphy, H., Scally, A., Andrew, D., Lord, J., Wyse, G., Fanning, N., Young, R. and Moore, N. (2022) ‘Clinical audit comparing radiation dose metrics between WEB and coil embolisation in the treatment of intracranial aneurysms’, Journal of Medical Imaging and Radiation Sciences, 53(1), pp. 75-80. doi: 10.1016/j.jmir.2021.11.013.en
dc.identifier.doi10.1016/j.jmir.2021.11.013en
dc.identifier.endpage80en
dc.identifier.issn1876-7982
dc.identifier.issued1en
dc.identifier.journaltitleJournal Of Medical Imaging And Radiation Sciencesen
dc.identifier.startpage75en
dc.identifier.urihttps://hdl.handle.net/10468/12687
dc.identifier.volume53en
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urihttps://www.sciencedirect.com/science/article/pii/S1939865421002976
dc.rights© 2021 Published by Elsevier Inc. on behalf of Canadian Association of Medical Radiation Technologists. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectCoilingen
dc.subjectWEBen
dc.subjectKAPen
dc.subjectESDen
dc.subjectICAen
dc.subjectWEB, Woven EndoBridgeen
dc.subjectKAP, kerma-area producten
dc.subjectESD, entrance skin doseen
dc.subjectRAK, reference air kermaen
dc.subjectDSA, digital subtraction angiographyen
dc.titleClinical audit comparing radiation dose metrics between WEB and coil embolisation in the treatment of intracranial aneurysms.en
dc.typeArticle (peer-reviewed)en
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