Dosis de radiación recibida por el paciente durante el tratamiento endovascular de los aneurismas de aorta abdominal

Riera-Del Moral, L.F.; Corredoira-Silva, E.; Sáez-Martín, L.; Gutiérrez-Nistal, M.; Fernández-Heredero, A.; Leblic-Ramírez, I.; Mendieta-Azcona, C.; Stefanov-Kiuri, S.; Fernández-Alonso, S.; Garzón-Moll, G.; Riera-De Cubas, L.

doi:10.1016/S0003-3170(06)74986-0

Información del artículo

Resumen

Bibliografía

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Estadísticas

Resumen

Introducción

Las técnicas endovasculares se utilizan cada vez con mayor frecuencia en el tratamiento de los aneurismas de aorta abdominal (AAA), para lo que es necesario emplear mayores dosis de radiación en los pacientes, tanto en el diagnóstico como en el procedimiento y su seguimiento posterior, que en el tratamiento quirúrgico convencional. Es imprescindible delimitar los niveles de referencia de dosis de radiación necesarios para la ejecución del procedimiento.

Objetivo

Cuantificar la dosis total que reciben los pacientes sometidos a esta modalidad de tratamiento.

Pacientes y métodos

Se analiza deforma observacional-prospectiva a 46 pacientes con AAA tratados mediante abordaje endovascular en el año 2004, de los cuales 27 reciben un montaje aortomonoilíacoy 19 bifurcado.

Resultados

Se obtiene una dosis de radiación total de 48,62 mSv el primer año; esta dosis no difiere entre los pacientes a los que se les coloca una endoprótesis aortomonoilíaca o una bifurcada.

Conclusiones

La dosis obtenida no produce un efecto nocivo apreciable el primer año en lo que respecta a efectos deterministas de la dosis empleada. La mayor parte de la dosis recibida se debe a los estudios con tomografía axial computarizada. La resonancia magnética puede jugar un papel muy importante para la reducción de la dosis necesaria en el futuro.

Palabras clave:

Aneurisma de aorta abdominal

Arteriografía

Dosis

Dosis efectiva

Endoprótesis

Endovascular Radiación

Tomografía axial computarizada

Summary

Introduction

It is becoming increasingly more frequent to treat abdominal aortic aneurysms (AAA) using endovascular techniques and as a result the doses of radiation patients receive, both in the diagnosis and intervention as well as in the ensuing follow-up, are higher than in conventional surgical treatment. It is essential to define the reference radiation dosage levels that are needed to perform the operation.

Aim

To quantify the total dose received by patients submitted to this kind of treatment.

Patients and methods

An observational-prospective study was conducted to analyse 46 patients with AAA who were treated using an endovascular approach in the year 2004; aortomonoiliac devices were utilised in 27 cases and 19 received bifurcated stents.

Results

A total radiation dose of 48.62 mSv was obtained in the first year; patients received the same dose regardless of whether an aortomonoiliac or a bifurcated stent had been placed.

Conclusions

The dose obtained does not give rise to any appreciable adverse effects in the first year as far as dosage-determined effects are concerned. The greater part of the dose received by patients is due to the computerised axial tomography scans that are carried out. Magnetic resonance imaging can play an important role in reducing the doses that are required in the future.

Key words:

Abdominal aortic aneurysm

Arteriography

Computerised axial tomography

Dose

Effective dose

Endovascular

Radiation

Stent

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