Factors affecting radiation dose, radiation exposure time and procedural time in arterial embolization for active hemorrhage

• Published in: Emergency radiology Vol. 31; no. 5; pp. 641 - 652
• Main Authors: Ghosn, Youssef, Khdhir, Mihran, Jabbour, Yara, Dushfunian, David, Kobeissi, Iyad, Abbas, Nada, Akkari, Chantal, Kahwaji, Eva-Maria, Muallem, Nadim
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2024; Springer Nature B.V
• Subjects: Adult; Age; Aged; Bleeding; Demographic variables; Dependent variables; Embolization; Embolization, Therapeutic - methods; Emergency Medicine; Female; Fluoroscopy; Hemorrhage; Hemorrhage - diagnostic imaging; Hemorrhage - therapy; Humans; Imaging; Independent variables; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patients; Pelvis; Radiation; Radiation Dosage; Radiation effects; Radiation Exposure; Radiography, Interventional; Radiology; Retrospective Studies; Sex; Time Factors; Procedural time; Arterial embolization; Radiation dose; Active bleed
• ISSN: 1438-1435; 1070-3004; 1438-1435
• DOI: 10.1007/s10140-024-02262-w

Purpose To evaluate patient and procedure-related factors contributing to the radiation dose, cumulative fluoroscopy time (CFT), and procedural time (PT) of Arterial Embolization (AE) for suspected active bleeding. Methods Data on patients who underwent AE for suspected bleeding was retrospectively gathered between January 2019 and April 2022. Data collected included the dependent variables consisting of dose-area product (DAP), CFT, PT, and independent variables consisting of demographic, bleeding-specific, and procedure-specific parameters. All statistical computations were performed in SPSS statistics. The alpha value was set at 0.05. Results Data from a total of 148 AE were collected with an average patient’s age of 61.06 ± 21.57 years. Higher DAP was independently associated with male sex ( p  < 0.002), age ranges between 46 and 65 years ( p  = 0.019) and > 66 years ( p  = 0.027), BMI above 30 ( p  = 0.016), attending with less than 10 years of experience ( p  = 0.01), and bleeding in the abdomen and pelvis ( p  = 0.027). Longer CFT was independently associated with attending with less than 10 years of experience ( p  < 0.001), having 2 ( p  = 0.004) or > 3 ( p  = 0.005) foci of bleed, and age between 46 and 65 years ( p  = 0.007) and ≥ 66 years ( p  = 0.017). Longer PT was independently associated with attending with less than 10 years of experience ( p  < 0.001) and having 2 ( p  = 0.014) or > 3 ( p  = 0.005) foci of bleed. Conclusion The interventionist experience influenced radiation dose, CFT and PT. Dose was also affected by patients’ sex, age, BMI, as well as bleeding location. CFT was also affected by patients’ age, and both CFT and PT were also affected by the number of bleeding foci. These findings highlight the multifaceted factors that affect radiation dose and procedural time, emphasizing the importance of interventionist expertise, patient’s age, sex, BMI, location and number of bleeds. Highlights Radiation dose to patients in arterial embolization was affected by the interventionist experience, patients’ sex, age, BMI, as well as bleeding location. Radiation exposure time was affected by the interventionist experience, patients’ age, and number of bleeding foci. Total procedure time was affected by the interventionist experience and number of bleeding foci. Unexpectedly, pre-procedural CTA, presence of active bleed, type of embolic material as well as other factors did not impact radiation dose, radiation exposure time or procedural time.