What imaging studies are necessary for abdominal aortic endograft sizing? A prospective blinded study using conventional computed tomography, aortography, and three-dimensional computed tomography

Abstract

Reproducible and comparable measures of diameter and length can be obtained by each of three imaging modalities available for endograft sizing. As a single imaging modality, 3D CT appears to have the best correlation for both diameters and lengths; however, the difference is not sufficient enough to alter endograft selection. Three-dimensional CT may be reserved for challenging aortic anatomy where small differences in measurements would affect patient or graft selection for EVAR.

Prospective intraindividual comparison of unenhanced magnetic resonance imaging vs contrast-enhanced computed tomography for the planning of endovascular abdominal aortic aneurysm repair

“…2,3 Contrast-enhanced computed tomography (CT) is the most widely used modality for obtaining these measurements in current clinical practice. [4][5][6] However, patients with aortic disease often have renal impairment and greater risk of contrast-induced nephropathy. Gadoliniumenhanced magnetic resonance imaging (MRI) was once considered an alternative to contrast-enhanced CT [7][8][9] ; however, since an association between gadolinium-based contrast agents and nephrogenic systemic fibrosis (NSF) was elucidated, gadolinium-enhanced MRI has been contraindicated for such patients.…”

Impact of 3-Dimensional-Computed Tomography Workstation for Precise Planning of Endovascular Aneurysm Repair

“…Both axial CT and angiography with measurement catheters result in significant differences, particularly shortening. 9,14 There were statistically significant differences in measurements of L1, L2, and L3 between CLF measurement and axial CT measurement in this study. Moreover, there were several discrepancies in device size selected by between CLF measurement and axial CT measurement.…”

“…Several reports have shown that measurements of aortic length and diameter using a 3-dimensional (3D)-computed tomography (CT) workstation are superior to those assessed angiographically. 8,9 Specialists in EVAR for complex aortic aneurysm have reported design and planning of fenestrated stent grafts and branched stent grafts using 3D-CT workstations. 10,11 The purpose of the current study was to evaluate the usefulness of using a 3D-CT workstation for planning EVAR in an institute with a small number of patients.…”

Effectiveness of proximal intra-operative salvage Palmaz stent placement for endoleak during endovascular aneurysm repair

“…Three-dimensional workstation planning has been considered useful by many 26,27 ; for example, Sobocinski et al 28 showed that it reduced the rate of type 1 endoleaks and Velazquez et al 29 indicated that it decreased the rate of extra iliac extension. We emphasise the importance of proper pre-EVAR planning, as this is one of the obvious factors that may compromise long-term durability and outcome.…”