Angles of the Branches of the Visceral Aorta: Implications for Complex Aneurysm Repairs

Abstract

Thoracoabdominal aortic aneurysms can require custom designed branched stent‐grafts. Visceral and renal artery orientations can change as more of this segment becomes aneurysmal. This study's purpose was to determine these orientations in infrarenal aneurysms as a baseline to compare to more complex proximal aneurysms. Aquarius TeraRecon 3D imaging software was used for morphological assessment of CT scans for 20 Infrarenal aneurysms. (15M, 5F, mean age=73.7). Four take off angles were measured. The clock‐face position (CFP) was noted in transverse sections for each. The direction of take off of the renal arteries was assessed (anterior, orthogonal and posterior) and maximal aortic aneurysm diameter was taken. The average take off angle was 63.06° in the Left Renal (LRA), 55.57° in the Right Renal (RRA), 60.07° in the Superior Mesenteric (SMA) and 56.82° in the Celiac Trunk (CT). The mode for CFP was 3:00 (n=8) in LRA, 10:00 (n=10) in RRA, 1:00 (n=9) in SMA and 1:00 (n=8) in CT. The mode for direction of take off angle was orthogonal (n=10) for LRA and anterior (n=12) for RRA. The mean maximal aneurysmal diameter was 57.95mm. The data suggests little variability in patients with Infrarenal aneurysms. This information will be used as a baseline as more proximal aneurysms are assessed.Grant Funding Source: Departmental