Introduction: Iatrogenic radiation exposure had become serious concern for the public sector. We investigated whether 3D roadmap angiography offers advantages over the conventional digital roadmap technique using biplane fluoroscopy to minimize radiation exposure to the patient.
Methods: From January 2012 through August 2013, a retrospective chart review was performed to identify cerebral aneurysm coil embolization procedures performed by 3 neurointerventionalists at our institution. Two of the neurointerventionalists used conventional digital roadmap technique throughout the review period, and one neurointerventionalist changed from the conventional roadmap technique to the 3D roadmap technique half way through the study period. Allowing for a transition period to master the 3D roadmap technique, the periods from 1/2012 to 8/2012 and 3/2013 to 7/2013 were analyzed for mean radiation dose, fluoroscopy time, and contrast administration. The 2 neurointerventionalists that used the conventional roadmap during both periods were grouped together for analysis (Group 1) and the third neurointerventionalist was analyzed separately (Group 2).
Results: A total of 209 aneurysm coil embolization procedures were identified. During the first period, there was no significant difference between the mean procedure radiation doses or fluoroscopy time between the 2 groups (Table 1). There was a significant difference in the amount of contrast administered during the first period. During the second period, there was no significant difference in the mean radiation dose. The fluoroscopy time was significantly lower for Group 2 and there was a trend for less contrast administration for Group 2.
Conclusions: There was no significant difference in radiation dose between the 3D roadmap and conventional digital roadmap techniques. The fluoroscopy time was significantly decreased for the 3D roadmap technique. The 3D roadmap technique thus may ultimately lower health care cost by eliminating the upfront hospital investment for a biplane angiography suite.
Patient Care: 3D roadmap techniques may help to standardize neuroendovascular surgery and lower health care cost.
Learning Objectives: To investigate the use of 3D roadmap technology during neuroendovascular procedures.