Radiation Exposure in Elective Endovascular Carotid Artery Stenting.

Authors

Sabine Sari, Jonas Wilde, Alexander Brose, Tobias Struffert

Published in

Clinical neuroradiology. Sep 28, 2026. Epub Sep 28, 2026.

Abstract

To systematically assess radiation exposure during elective carotid artery stenting (CAS) for symptomatic extracranial carotid stenosis at a high-volume centre and to generate data that support optimization of both radiation dose and procedural workflow, thereby providing a basis for future multicentre studies aimed at establishing diagnostic reference levels.
Demographic (age, gender, BMI), procedural (balloon dilatations, procedure time), dosimetric (dose-area product [DAP], fluoroscopy time, number of acquisition series), anatomical, and interventionalist-related factors were retrospectively analysed in 109 patients undergoing CAS on a biplane flat-panel system using a standardized workflow and dedicated low-dose protocol. Nonparametric statistics were applied; p < 0.05 was considered significant.
Mean total DAP was 3342.12 ± 1679.36 cGy·cm² (median 2884.61 cGy·cm²), with fluoroscopy contributing 47% (mean 1666.37 ± 1122.03 cGy·cm²). Gender, anatomical side, and stenosis characteristics had no significant impact, whereas age and BMI were positively associated with total DAP (p = 0.047 and 0.014). Total DAP correlated with procedure time (rₛ = 0.491, p < 0.001), fluoroscopy time (rₛ = 0.666, p < 0.001), and number of acquisition series (rₛ = 0.364, p < 0.001). Plane A was used more frequently than plane B (p < 0.001). Procedures performed by the senior interventionalist (> 20 years experience) showed significantly lower fluoroscopy DAP (p = 0.004), shorter procedure and fluoroscopy times, and fewer acquisition series.
Elective CAS can be performed with low radiation exposure using standardized workflows and low-dose imaging. Radiation exposure is influenced by patient characteristics, procedural factors, and interventionalist experience. These data may provide a foundation for future multicentre studies aimed at establishing DRLs and optimizing dose-reduction strategies in neuroendovascular practice.

PMID:
42803796
Bibliographic data and abstract were imported from PubMed on 28 Sep 2026.

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