CO2-guided EVAR exhibits substantial radiation dose variability, driven by angiographic system generation, software, and synchronization protocols. Modern systems with optimized low-dose protocols and CO2-DSA synchronization reduce radiation exposure to levels comparable to ICM-based EVAR.Clinical ImpactThis large multicenter prospective study establishes a reliable radiation dose benchmarks for CO2-guided endovascular aortic repair (EVAR), showing that modern angiographic systems with optimized low-dose protocols and synchronized CO2-digital subtraction angiography achieve median dose-area product values comparable with conventional iodinated contrast media EVAR, thereby dispelling concerns about excessive radiation exposure with CO2-guided EVAR.
Chisci et al. (Tue,) studied this question.