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Original research
Radiation exposure, and procedure and fluoroscopy times in endovascular treatment of intracranial aneurysms: a methodological comparison
  1. Nicholas K Cheung1,2,
  2. Michelle Boutchard1,
  3. Michael W Carr1,
  4. Jens J Froelich1,2
  1. 1 Department of Medical Imaging, Royal Hobart Hospital, Hobart, Tasmania, Australia
  2. 2 Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  1. Correspondence to Professor Jens J Froelich, Department of Medical Imaging Royal Hobart Hospital Hobart Tasmania Australia ; jens.froelich{at}


Background Limited data are available for radiation exposure, and procedure and fluoroscopy times in neuroendovascular treatment (NET) strategies.

Objective This study establishes and compares related parameters between coil embolization (COIL), balloon assisted coil embolization (BAC), stent assisted coil embolization (SAC), and flow diverting technology (FDT) in NET of intracranial aneurysms.

Materials and methods Between 2010 and 2017, 249 consecutive intracranial aneurysms underwent NET at a single center, all performed by the same operator. Dose area products (DAP), and procedure and fluoroscopy times were recorded and compared between COIL, BAC, SAC, and FDT techniques. Differences in parameters between cohorts were analyzed for significance using the Mann–Whitney U test, unpaired t test and χ2test. Additional subgroup analysis was performed for emergency and elective cases.

Results 83 aneurysms were treated with COIL (33%), 72 with BAC (29%), 61 with SAC (25%), and 33 with FDT (13%). Baseline characteristics were largely similar within these groups (P>0.05). Among COIL, BAC, and FDT cohorts, no significant difference was found for mean DAP, or procedure and fluoroscopy times (P>0.05). However, compared with all other cohorts, SAC was associated with a significantly higher DAP and longer procedure and fluoroscopy times (P<0.005). No significant difference was recorded for emergency and elective case subgroups.

Conclusion Compared with other NET strategies, SAC was associated with a significantly higher DAP, and longer procedure and fluoroscopy times. This study provides an initial dataset regarding radiation exposure, and procedure and fluoroscopy times for common NET, and may assist ALARA (As Low As Reasonably Achievable) principles to reduce radiation risks.

  • aneurysm
  • coil
  • stent
  • flow diverter

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  • Contributors All authors made substantial contributions to the design of the study, and analysis and interpretation of the data. All authors drafted and/or revised it critically, and provided final approval of the version to be published. All authors agree to be accountable for every aspect of the work in ensuring that questions related to the accuracy or integrity of any of the content are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the Tasmanian Human Research Ethics Committee (approval reference H0016850).

  • Provenance and peer review Not commissioned; externally peer reviewed.