[National Survey on Procedure Dose of Endovascular Treatment for Lower Extremity Artery Disease].

Purpose: The objective of this study is to elucidate the current status of procedural radiation doses for endovascular treatment (EVT) of lower extremity artery disease (LEAD) in Japan and to validate the diagnostic reference level (DRL) quantity.

Methods: Survey requests were mailed to 493 facilities across Japan. The study targeted cases of EVT for LEAD performed between April 1, 2020, and March 31, 2022, with a maximum of 10 cases collected per facility. We investigated the displayed values of cumulative air kerma at the patient entrance reference point (K), the air kerma-area product (P) and the fluoroscopy time (FT) for all EVT procedures for LEAD (All EVT) and by treatment site.

Results: Data were collected from 1638 cases across 167 facilities. The median values for All EVT were K: 150 mGy, P: 30 Gy·cm, and FT: 28.6 min. The highest K and P were observed in the aortoiliac (AI) region (286 mGy, 59 Gy·cm), while the lowest were in the below-the-knee (BTK) region (81 mGy, 15 Gy·cm) (p<0.001). The shortest FT was recorded in the AI region with a median of 23.8 min and the longest in the BTK region at 32.2 min (p<0.001). Significant differences in K, P, and FT were observed across the treatment sites for EVT for LEAD (p<0.001).

Conclusion: In EVT for LEAD, it is necessary to set the DRL quantity according to the anatomical site being treated, using the dose values indicated by the angiographic equipment, such as K and P.