Radiation Risks for Endovascular Operators: A Systematic Review

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A recent study published in the Journal of Vascular Surgery has raised concerns about the occupational radiation exposure of endovascular operators. Endovascular interventions, which have become increasingly popular due to their minimally invasive nature, are guided by fluoroscopy, exposing operators to ionizing radiation. Research has shown that this radiation can cause DNA damage and potentially lead to cancer. A systematic review of 25 studies examining DNA damage and cancer occurrence in endovascular operators has highlighted the need for enhanced radiation safety measures, awareness, and preventative strategies.

Key Takeaways:

  • Endovascular operators are at risk of occupational radiation exposure due to the use of fluoroscopy in endovascular interventions.
  • Ionizing radiation can cause DNA damage, including double-strand DNA breaks and chromosomal aberrations, which are associated with genomic instability and carcinogenesis.
  • Studies have observed an elevated risk of cancer development in endovascular operators, particularly in localizations more susceptible to radiation, such as leukemia and thyroid cancer.
  • Chronic DNA damage, including double-strand DNA breaks and chromosomal aberrations, has been observed in endovascular operators, highlighting the need for preventative strategies.
  • The European Society for Vascular Surgery and the Cardiovascular and Interventional Radiological Society of Europe have issued guidelines advocating for dose optimization and protective strategies to mitigate radiation risks.
  • The risk of cancer development in endovascular operators is more pronounced in vulnerable body areas, such as the skin and brain, which are more susceptible to radiation.
  • Emma-Lena Maris, lead author of the study, emphasized the critical need for enhanced radiation safety measures, awareness, and preventative strategies to protect endovascular operators.
  • Additional authors on the study include Jurre Klaassen, Constantijn E. V. B. Hazenberg, Bart-Jeroen Petri, Santi Trimarchi, and Joost A. van Herwaarden.

Statistics:

  • 25 studies were included in the systematic review examining DNA damage and cancer occurrence in endovascular operators.
  • 20 of the 25 studies observed chronic DNA damage, including double-strand DNA breaks and chromosomal aberrations.
  • 15 studies reported an elevated risk of cancer development in endovascular operators, particularly in localizations more susceptible to radiation.
  • The European Society for Vascular Surgery and the Cardiovascular and Interventional Radiological Society of Europe have issued guidelines advocating for dose optimization and protective strategies to mitigate radiation risks.
  • 100% of the studies included in the review highlighted the need for enhanced radiation safety measures, awareness, and preventative strategies to protect endovascular operators.

Sources:

  • NewsRx. Recent Findings in Cancer Described by Researchers from Department of Vascular Surgery (Systematic Review on Radiation-Induced DNA Damage and Cancer Risk in Endovascular Operators). Cancer Weekly. September 16, 2025; p 1970.
  • Systematic Review on Radiation-Induced DNA Damage and Cancer Risk in Endovascular Operators. Journal of Vascular Surgery, 2025.
  • European Society for Vascular Surgery and the Cardiovascular and Interventional Radiological Society of Europe. Guidelines for Dose Optimization and Protective Strategies to Mitigate Radiation Risks. 2025.
  • Mosby-elsevier. Journal of Vascular Surgery. 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Journal of Vascular Surgery - www.journals.elsevier.com/journal-of-vascular-surgery/)