Many hybrid operating suites in Australia are nearing their effective-life age limit. Fluoroscopy machines will need replacing to optimise imaging quality, minimise radiation exposure to staff and patients - and enable ongoing Medicare billing. As replacement takes several months, service continuity using other equipment is essential. Studies have also suggested that mobile imaging systems, compared to fixed imaging systems may minimised radiation exposure to operating room staff and patients, however, there is a paucity of information on this topic. We examined the effectiveness and safety of using mobile C-arm imaging in a standard operating suite to ensure continuity of vascular service in a tertiary trauma unit.

All patients undergoing endovascular intervention over 4-months were enrolled. 2 months using the hybrid suite (HS) followed by 2 months using mobile imaging in a standard theatre (MI). Data was collected prospectively, including operative details, fluoroscopy time, radiation dose and theatre time.

248 patients had an endovascular procedure: 151 peripheral arterial angiograms (67 HS vs 84 MI), 38 venograms (17 HS vs 21 MI) and 59 fistulograms (33 HS vs 26 MI). Radiation dose was significantly lower with MI for peripheral arterial angiograms (HS vs MI: 81 vs 12 Gycm2, p<.001), venogram (158 vs 27 Gycm2, p <0.01) and fistulogram (27 vs 3 Gycm2, p <0.01), with no significant difference in fluoroscopy time for any group. Total theatre time was similar between imaging cohorts (Mean HS vs MI: Overall 114 vs 113mins, p=0.98; peripheral arterial angiogram 127 vs 126mins, p=0.95; venogram 102 vs 107mins, p=0.79; fistulogram 92 vs 76mins, p=0.21).

Conclusion: Modern mobile imaging allows safe continuity of a vascular service using a standard theatre during hybrid suite upgrade. Theatre time per case is not significantly increased and radiation dose is reduced. The significant reduction in radiation exposure with modern equipment supports upgrading fluoroscopy equipment