Introduction/purpose Interventional stroke management has seen a period of explosive growth in the wake of recent trials demonstrating improved outcomes in patients who undergo timely and appropriate procedural management. The two most common interventional techniques involve the use of stent retrieval devices and suction aspiration. In the setting of demonstrable clinical benefit to the patient in these procedures, further exploration of intraprocedural radiation exposure to the patient and operator is warranted. While radiation exposure for the patient in any one procedure is unlikely to produce a clinically-evident adverse event, chronic exposure to the operator may carry significant risk. Our goal is to determine the difference, if any, in fluoroscopy time (FT) and dose area product (DAP) for the use of these devices.
Materials and methods We examined data for interventional stroke management cases performed for M1 segment occlusions at Duke University Medical Center from the period of January 2014 to January 2016 with regards to fluoroscopy time and dose area product. Cases were subdivided into those only utilizing stent retrieval devices (SolitaireTM; Covidien, Dublin, Ireland) and those only utilizing suction aspiration devices (Penumbra®, Alameda, CA). Mean fluoroscopy time and dose area product, as well as standard deviations were calculated for each technique and compared using Student’s t-test.
Results The fluoroscopy time and dose area product for interventional management of vascular occlusions using suction aspiration and stent retriever devices in a selected group of patients is given in the table.
Conclusion Data from this limited subset of patients suggest a statistically significant difference in fluoroscopy time for mechanical thrombectomies performed with stent retrieval versus those performed with suction aspiration. No significant difference was seen in dose area product data.
The difference in fluoroscopy time between the two techniques may reflect operator comfort rather than intrinsic differences between the two techniques. Notably, however, these data were obtained across multiple operators at our institution, so it may be plausible that these differences are generalizable to technique. It is important to again note that these differences in radiation exposure are unlikely to result in clinical effect in an individual patient, but differences in exposure to the operator over a career may be significant. Further exploration with larger patient samples is warranted.
Disclosures P. Brown: None. M. Cobb: None. T. Smith: None. A. Zomorodi: None. L. Gonzalez: None.
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