ABSTRACT
Ionizing radiation (in the form of X-rays) is used for the majority of procedures in interventional radiology. This review article aimed at promoting safer use of this tool through a better understanding of radiation dose and radiation effects, and by providing guidance for setting up a quality assurance program. To this end, the authors describe different radiation descriptive quantities and their individual strengths and challenges, as well as the biologic effects of ionizing radiation, including patient-related effects such as tissue reactions (previously known as deterministic effects) and stochastic effects. In this article, the clinical presentation, immediate management, and clinical follow-up of these injuries are also discussed. Tissue reactions are important primarily from the patients' perspective, whereas stochastic effects are most relevant for pediatric patients and from an occupational viewpoint. The factors affecting the likelihood of skin reaction (the most common tissue reaction) are described, and how this condition should be managed is discussed. Setting up a robust quality assurance program around radiation dose is imperative for effective monitoring and reduction of radiation exposure to patients and operators. Recommendations for the pre-, peri-, and postprocedure periods are given, including recommendations for follow-up of high-dose cases. Special conditions such as pregnancy and radiation recall are also discussed.
ABSTRACT
BACKGROUND: We report two cases of vascular complications after reconstructive pelvic surgery successfully treated with pelvic artery embolization. CASES: Two patients who underwent mesh placement complicated by postoperative pelvic hemorrhage were treated successfully with selective arterial embolization. CONCLUSION: The widespread adoption of reconstructive pelvic surgery procedures with dissection in deep vascular spaces has brought with it the prospect of challenging vascular morbidity. A thorough understanding of pelvic anatomy is essential for management of vascular complications from reconstructive pelvic surgery.
