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is important to the surgeon, to staff, and the patient. Yet this topic receives very little attention in the literature, at our meetings, in our training, and, I suspect, in our daily practice. Although this study described here is quite simple, they just basically measured the dosimetry on the three surgeons, and although there is not a whole lot of science behind this, I believe this paper nevertheless is very important. It certainly shows that the annual radiation dose to each of the three surgeons fell within the recommended exposure limits and therefore, we can go ahead and do these procedures relatively safely. However, it was interesting to note that the calculated radiation exposure to the eyes and to the areas external to the lead shields were not that insignificant. I did some calculations and your average millisievert radiation dose to the eye was 5 per year, and you have to remember that we're going to be practicing for approximately 20 to 30 years so if you multiply that then you get over 100 to 120 over your career plus you have the ambient daily exposure from the environment, the sun, the cosmic rays, etc, which is another 3 to 5 per year so that during your career lifetime, you can easily get over 200 mSv and that is certainly enough to cause cataracts and other eye disorders. Remember that the radiation effects are cumulative and they are permanent as Dr Lipsitz pointed out. So I would urge all of you to take great caution. Read the manuscript. It is very well written. It gives some very good pearls on what to do to try to minimize your radiation exposure. I really only have one question to the authors. I noted that one of your surgeons had much less radiation exposure than the other two. What did he do differently because I want to know? Dr Evan C. Lipsitz. The surgeon with the least exposure tended to be the fellow who did less of the procedure. We generally have two attendings involved in all of these cases and a fellow. If you're going to be doing these procedures with two surgeons, I don't think you can necessarily add the doses of the three surgeons here, but the dose of two surgeons performing these procedures would certainly be higher than the doses of the two out of the three surgeons that we presented. Thank you for your comments Dr Ahn. Radiation exposure to patients and medical personnel during radio frequency catheter ablation for supraventricular Radiation Exposure in Endovascular Surgery of the Head and Neck Naoya Kuwayama, Akira Takaku, Shunro Endo, Michiharu Nishijima, and Tetsuya Kamei PURPOSE: To evaluate the radiation risk to the operator and the patient during endovascular surgery of the head and neck. METHODS: The dose was measured using thermoluminescence dosimeters attached at the body surface of the operator and the patient during 15 endovascular surgeries (3 for arteriovenous malformation, 8 for dural arteriovenous fistulas, and 4 for other disorders of the head and neck). The dose was measured at seven sites on the operator and at fi ve sites on the patient. RESULTS: The mean number of digital subtraction angiography studies and fluoroscopy time were 21 ::':: 10 and 73 ::':: 24 minutes, respectively. The equivalent dose range at each site in the operator was 0.12 to 0.88 mSv (glabella}, 0.06 to 1.1 and 0 to 0.09 mSv (neck, outside and inside the protector, respectively}, 0 to 0.20 mSv (left shoulder, inside the protector), 0.09 to 1.99 mSv (left arm), 0.05 to 3.55 mSv (left hand}, and 0 to 0.49 m Sv (pubis, inside the protector). Those in the patients were 3.1 to 136 mSv (glabella), 13 to 5441 mSv (right temporal area), 4 to 186 mSv (left temporal area), 0.1 to 51 mSv (neck}, and 0 to 0.62 mSv (pubis}. CONCLUSIONS: The total doses at the operator's eyes and left hand during the course of a year may exceed the dose limits recommended by
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