PURPOSE To evaluate the patient and the neurointerventionalist radiation dose levels during endovascular treatment of acute ischemic stroke, and to analyze factors affecting doses. MATERIALS AND METHODS From October 2017 to January 2019, we prospectively collected patient radiation data and neurointerventionalist data from real-time dosimetry from all consecutive thrombectomies. Multivariate analysis was performed to analyze patient total dose area product (DAP) and neurointerventionalist dose variability in terms of clinical characteristics and the technical parameters of thrombectomies. Local dose reference levels (RL) were derived as the 75th percentile of the patient dose distributions. RESULTS A total of 179 patients were treated during the study period and included in this study. Local dose RL for thrombectomy was derived for total DAP to 34 Gy cm2, cumulative air kerma of 242 mGy and fluoroscopy time of 12 min. The mean neurointerventionalist dose for thrombectomy was 7.7 ± 7.4 µSv. Height (P = 0.018), weight (P = 0.004), body mass index (P = 0.015), puncture to recanalisation (P < 0.001), fluoro time (P < 0.001), number of passes (P < 0.001), thrombolysis in cerebral infarction 2b/3 recanalisation (P = 0.034) and aspiration thrombectomy (P < 0.001) were independent factors affecting patient total DAP, whereas baseline National Institutes of Health Stroke Scale (P = 0.043), puncture to recanalisation (P = 0.003), fluoroscopy time (P = 0.009) and number of passes (P = 0.009) were factors affecting the neurointerventionalist dose. CONCLUSION New reference patient doses lower than those in previously published studies were defined. However, the operator's doses were higher than those in the only available study reporting on operator's dose during cerebral interventions.

中文翻译：

---

神经介入治疗和患者放射剂量在急性缺血性卒中的血管内治疗中的作用。

目的评估急性缺血性脑卒中的血管内治疗过程中患者和神经介入治疗师的剂量水平，并分析影响剂量的因素。材料与方法从2017年10月至2019年1月，我们从所有连续的血栓切除术患者的实时剂量测定中前瞻性收集了患者辐射数据和神经介入治疗数据。进行多变量分析以根据临床特征和血栓切除术的技术参数分析患者的总剂量面积积（DAP）和神经介入治疗师的剂量变异性。局部剂量参考水平（RL）得出患者剂量分布的第75个百分点。结果在研究期间共治疗了179例患者，并纳入本研究。血栓切除术的局部剂量RL得出总DAP为34 Gy cm2，累积空气比释动能为242 mGy，透视时间为12分钟。血栓切除术的平均神经介入治疗剂量为7.7±7.4 µSv。身高（P = 0.018），体重（P = 0.004），体重指数（P = 0.015），穿刺再通气（P <0.001），氟时间（P <0.001），通过次数（P <0.001），溶栓脑梗死2b / 3再通（P = 0.034）和血栓切除术（P <0.001）是影响患者总DAP的独立因素，而美国国立卫生研究院基线卒中量表（P = 0.043），穿刺再通（P = 0.003） ，透视时间（P = 0.009）和通过次数（P = 0.009）是影响神经介入治疗剂量的因素。结论确定了低于先前发表的研究中的新参考患者剂量。然而，手术者的剂量高于仅在大脑干预期间报告手术者剂量的现有研究中的剂量。