SIR 2024
Embolization
Raj Ayyagari, MD (he/him/his)
Associate Professor of Radiology
Boston Medical Center
Disclosure information not submitted.
Saumik Z. Rahman, MD
Resident Physician
Yale New Haven Hospital
Disclosure information not submitted.
Kevin Grizzard, PhD
Assistant Professor
Yale University School of Medicine
Disclosure information not submitted.
Adel Mustafa, PhD
Associate Professor
Yale University School of Medicine
Disclosure information not submitted.
Jessica Lee, MD
Assistant Professor of Clinical Radiology and Biomedical Imaging
Yale School of Medicine
Disclosure information not submitted.
Fabian M. Laage Gaupp, MD
Interventional Radiologist
Yale School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Shivank Bhatia, MD
Professor of Interventional Radiology
University of Miami
Financial relationships: Full list of relationships is listed on the CME information page.
Tiago Bilhim, MD, FSIR
Interventional Radiologist
SAMS Hospital, Portugal
Disclosure information not submitted.
Francisco Cesar Carnevale, MD, PhD (he/him/his)
Medical Coordinator
University Of Sao Paulo, Brazil
Financial relationships: Full list of relationships is listed on the CME information page.
Aaron M. Fischman, MD, FSIR, FCIRSE, FSVM
Professor, Diagnostic, Molecular and Interventional Radiology
Icahn School of Medicine at Mount Sinai
Disclosure information not submitted.
Ari Isaacson, MD, FSIR
Interventional Radiologist; Chair of Quality & Research
Prostate Centers USA
Disclosure information not submitted.
Tim McClure, MD
Assistant Professor of Radiology and Urology
Weill Cornell Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Justin McWilliams, MD, FSIR
Professor of Interventional Radiology
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
Charles Nutting, DO, FSIR
Interventional Radiologist
ECCO Medical
Disclosure information not submitted.
Andrew Richardson, MD MBA (he/him/his)
Interventional Radiology Resident
Jackson Memorial Hospital
Disclosure information not submitted.
Riad Salem, MD, FSIR, MBA
Professor
Northwestern Memorial Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
Marc Sapoval, MD, PhD
Head vascular and Oncological Interventional Radiology
Hopital Europeen Georges Pompidou, France
Financial relationships: Full list of relationships is listed on the CME information page.
Hyeon Yu, MD, FSIR (he/him/his)
Professor
University of North Carolina at Chapel Hill School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Fluoroscopy time (FT), cumulative air kerma (CAK), and field of view area (FoV) data were retrospectively collected for 1387 PAE procedures performed on fixed interventional fluoroscopic units from January 2014 to January 2022, by operators with >10 years of PAE experience from 10 high-volume centers ( >75 procedures) worldwide. CAK, FT, and kerma-area product (KAP) were plotted against sequential procedure number for each site. Piecewise linear segmented regression identified optimal curve breakpoints as cutoffs to exclude operator learning curve procedures that might skew data1. Mean/median effective dose (ED) were calculated and radiation-related adverse events tabulated for all included procedures. Excess relative risk of cancer-related death from PAE was calculated using the International Commission on Radiological Protection extrapolation model of 4.1-4.8%/Sv of ED2.
Results: 42 learning curve procedures from 1 center were excluded. Radiation dose data were analyzed for 1345 PAE procedures (Table). Mean values across all centers were FT=40.2±12.0 min, CAK=1315±510 mGy, KAP=194±75 Gy×cm2, and ED=21.4±8.2 mSv. Median overall ED was 18.0 mSv, with no reported 90-day deterministic-type adverse events. Calculated median excess relative risk of cancer-related death from PAE was 0.08–0.09%.
Conclusion: PAE performed by experienced operators at high-volume centers resulted in low patient radiation doses with no deterministic adverse events and minimal excess risk for stochastic events.