Introduction and Significance

The field of vascular surgery has seen a steep increase in the use of X-ray guided endovascular procedures over the past two decades. Although these minimally invasive techniques have many benefits, such as lower morbidity and shorter hospital stays, they also lead to increased exposure to radiation for both patients and healthcare providers. As such, there's a growing need for specific radiation protection guidelines in vascular surgery.

Why Guidelines Are Necessary

Despite the progress and popularity of endovascular procedures, there's a notable lack of awareness and education concerning radiation risks among healthcare staff. To bridge this gap, a vascular surgical society has drafted guidelines to raise awareness and set best practices in radiation safety for endovascular procedures. These guidelines aim not only to protect the healthcare team but also to offer more robust radiation safety measures for the patients.

Who Contributed

The guidelines were developed by a diverse team comprising 14 experts, including vascular surgeons, interventional radiologists, a radiation protection scientist, and a medical physicist. They reviewed the best available evidence and incorporated expert opinions.

Methodology

Strategy: Decisions were reached during a virtual meeting held on February 18, 2022. If consensus couldn't be reached, majority voting was used.

Literature Search: Comprehensive research was conducted through multiple databases like Medline, Embase, and the Cochrane Library. Criteria for literature selection were outlined, including language and the level of evidence.

Evidence Grading: The guidelines utilize the European Society of Cardiology (ESC) grading system to weigh the level of evidence and expert opinion for each recommendation.

Future Directions: These guidelines will be updated periodically based on new evidence and feedback. Despite being a guidance document rather than a standard of care, it is a critical step in creating a safer work environment in the field of vascular surgery.

Key Takeaways

The rapid increase in X-ray guided endovascular procedures has escalated radiation exposure risks.
The newly drafted guidelines fill a significant educational gap concerning radiation safety.
A multidisciplinary team of experts has put together these guidelines.
Methodologically sound procedures were followed in the drafting of the guidelines.
Periodic updates are expected to improve and fine-tune these recommendations.
By understanding and implementing these guidelines, vascular surgery professionals can promote a safer, more effective practice environment for both healthcare providers and patients.

Article: 

Editor’s Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety

Bijan Modarai a,*, Stéphan Haulon a, Elizabeth Ainsbury a, Dittmar Böckler a, Eliseo Vano-Carruana a, Joseph Dawson a, Mark Farber a, Isabelle Van Herzeele a, Adrien Hertault a, Joost van Herwaarden a, Ashish Patel a, Anders Wanhainen a, Salome Weiss a

ESVS Guidelines Committee b, Frederico Bastos Gonçalves, Martin Björck, Nabil Chakfé, Gert J. de Borst, Raphaël Coscas, Nuno V. Dias, Florian Dick, Robert J. Hinchliffe, Stavros K. Kakkos, Igor B. Koncar, Philippe Kolh, Jes S. Lindholt, Santi Trimarchi, Riikka Tulamo, Christopher P. Twine, Frank Vermassen

Document Reviewers c, Klaus Bacher, Elias Brountzos, Fabrizio Fanelli, Liliana A. Fidalgo Domingos, Mauro Gargiulo, Kevin Mani, Tara M. Mastracci, Blandine Maurel, Robert A. Morgan, Peter Schneider

https://www.ejves.com/action/showPdf?pii=S1078-5884%2822%2900546-9