We thank Dr Patelis for his thought provoking letter. The risk of working with radiation is evident but still largely uncertain. There is no “radiation free” option for most specialists, certainly not for residents who are young and require great exposure in a short period of time, but also for nurses and anaesthetists. In short, we are compelled to put ourselves in harm's way to do our job. With the endovascular revolution, our practice now takes place in a dangerous environment, a fact that must be acknowledged.
This is one big mammoth we can hardly control, let alone ignore.
One cannot rely solely on ethics for radiation safety, we should strive for stricter regulation to protect professionals. This entails substantial investment in safety and monitoring equipment, improved risk assessment, enforcement of risk reduction measures, and obligatory (re)certification in radiation management. Administrators and physicians who do not comply need to be liable. Scientific societies and other professional associations, political stakeholders, and scientific publications like that of Massiot et al.
1all play a role.
- Massiot N.
- Abdallah I.B.
- Duprey A.
- Leygnac S.
- Corcos O.
- Cadtier Y.
- et al.
Multicentre evaluation of an extra low dose protocol to reduce radiation exposure in superior mesenteric artery stenting.
Eur J Vasc Endovasc Surg. 2020; 60: 925-931
This elephant is not leaving the room. We must learn to tame it.
- Multicentre evaluation of an extra low dose protocol to reduce radiation exposure in superior mesenteric artery stenting.Eur J Vasc Endovasc Surg. 2020; 60: 925-931
Published online: October 13, 2020
Accepted: September 11, 2020
Received: September 9, 2020
© 2020 European Society for Vascular Surgery. Published by Elsevier B.V.
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- Re “The Elephant in the Operating Room”European Journal of Vascular and Endovascular SurgeryVol. 61Issue 1
- PreviewI read the work by Massiot et al.1 and the commentary by Gonçalves and Chakfé2 with great interest. Technology has provided us with high resolution imaging equipment allowing us to perform demanding procedures at a fraction of the exposure of older devices. In most centres, low dose protocols and radiation safety training are already in place. However, daily exposure to radiation should not be underestimated as its cumulative effects could take decades to be evaluated. Because of the poly-aetiological nature of some pathologies (e.g.
- Ethics in Occupational Exposure Needs a Green New DealEuropean Journal of Vascular and Endovascular SurgeryVol. 61Issue 1
- PreviewWe would like to thank Dr Patelis for his relevant comments regarding the worrying issue of long term occupational exposure.1 We definitely agree that it is the real question lying behind all the recent literature regarding radiation. By law in France, staff are supposed to be trained, monitored, and adequately equipped against radiation. This is the institution's responsibility. On an individual basis, every operator has the moral responsibility of justification and optimisation. Justification questions the indication.
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