Comparison of Patient Radiation Dose and Contrast Use during EVAR in a Dedicated Hybrid Vascular OR and Mobile Imaging

Background: The aim of the study is to determine whether performing endovascular aortic aneurysm repair (EVAR) in a dedicated vascular hybrid operating room (OR) is associated with a decreased patient radiation and contrast dose compared with mobile C-arm imaging in a conventional OR. Methods: This is a retrospective study of patients undergoing standard EVAR from 2009–2016. “Standard EVAR” was defined as the elective EVAR performed with bifurcated graft for infrarenal aneurysm with no iliac aneurysms. Patients were divided into 2 groups. Group 1 included EVARs performed in conventional theater with a mobile C-arm (January 2009 to June 2012) and group 2 EVARs performed in the dedicated vascular hybrid OR (July 2012 to December 2016). Data collected included patient demographics, aneurysm diameter, neck length, radiation dose, screening time, and contrast use of each patient. Results: There were 286 patients, 78 and 208 patients in group 1 and 2, respectively. There was no difference in age (77.6 years [76.3–78.9] vs. 76.6 years [75.9–77.9], P > 0.05), body mass index (26.5 kg/m² [25.1–28.0] vs. 27.9 kg/m² [27.1–28.7] P > 0.05), and mean aneurysm diameter (6.48 cms [6.13–6.82] vs. 6.81 cms [6.0–7.7], P > 0.05) between groups. Patients in group 2 received approximately half the mean radiation dose (16,807 cGy cm² [±11,078] vs. 8,233 cGy cm² [±7,471], P < 0.001), shorter fluoroscopy time (36.02 min [±21.3] vs. 26.96 min [±19], P = 0.001), and less contrast use (114 mls [±44.2] vs. 158 mls [±63.9], P < 0.001). Conclusions: Performing EVAR in a dedicated vascular Hybrid OR may be associated with a lower patient radiation dose, shorter screening time, and less contrast use than performing EVAR in a conventional OR.