Abdominal aortic aneurysm morphology in candidates for endovascular repair evaluated with spiral computed tomography and digital subtraction angiography

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Abdominal aortic aneurysm morphology in candidates for endovascular repair evaluated with spiral computed tomography and digital subtraction angiography. / Resch, Tim; Ivancev, Krassi; Lindh, Mats; Nirhov, Nikolaj; Nyman, Ulf; Lindblad, Bengt.

In: Journal of Endovascular Surgery, Vol. 6, No. 3, 1999, p. 227-232.

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TY - JOUR

T1 - Abdominal aortic aneurysm morphology in candidates for endovascular repair evaluated with spiral computed tomography and digital subtraction angiography

AU - Resch, Tim

AU - Ivancev, Krassi

AU - Lindh, Mats

AU - Nirhov, Nikolaj

AU - Nyman, Ulf

AU - Lindblad, Bengt

PY - 1999

Y1 - 1999

N2 - PURPOSE: To analyze the morphology of abdominal aortic aneurysms (AAAs) and to study the usefulness of spiral computed tomography (CT) versus digital subtraction angiography (DSA) in the evaluation of patients for endovascular repair. METHODS: Of 133 AAA patients (120 men, mean age 67 years, range 52 to 84) evaluated preoperatively with CT imaging, 77 endograft candidates (68 men) were also assessed with intra-arterial DSA. Arterial parameters were measured on axial CT scans and angiographic films for comparison. RESULTS: Mean maximum AAA diameter was 58 +/- 11 mm (range 39 to 95). Aneurysmal neck diameter was consistently smaller on DSA than on CT (20.7 +/- 3.6 mm versus 23.0 +/ 3.5 mm, p < 0.0001). The distance from the most distal renal artery to the aortic bifurcation was longer on angiography than on CT (mean difference 10.0 mm, p < 0.0001). There was a positive correlation between the maximum AAA diameter and the AAA length (r = 0.49, p < 0.0001) and an inverse relationship between the neck length and the neck diameter (r = -0.36, p < 0.0001). No correlation was found between the maximum AAA diameter and maximum iliac diameter, angulation, or length. CONCLUSIONS: AAA anatomy varies widely and independently of the aneurysm size. Therefore, the maximum size of the aneurysm is a poor predictor of whether or not an aneurysm is suitable for endovascular repair. The discrepancy between angiographic and axial CT measurements suggests that neither alone is sufficient as a preoperative imaging technique when evaluating a patient for an endovascular graft procedure.

AB - PURPOSE: To analyze the morphology of abdominal aortic aneurysms (AAAs) and to study the usefulness of spiral computed tomography (CT) versus digital subtraction angiography (DSA) in the evaluation of patients for endovascular repair. METHODS: Of 133 AAA patients (120 men, mean age 67 years, range 52 to 84) evaluated preoperatively with CT imaging, 77 endograft candidates (68 men) were also assessed with intra-arterial DSA. Arterial parameters were measured on axial CT scans and angiographic films for comparison. RESULTS: Mean maximum AAA diameter was 58 +/- 11 mm (range 39 to 95). Aneurysmal neck diameter was consistently smaller on DSA than on CT (20.7 +/- 3.6 mm versus 23.0 +/ 3.5 mm, p < 0.0001). The distance from the most distal renal artery to the aortic bifurcation was longer on angiography than on CT (mean difference 10.0 mm, p < 0.0001). There was a positive correlation between the maximum AAA diameter and the AAA length (r = 0.49, p < 0.0001) and an inverse relationship between the neck length and the neck diameter (r = -0.36, p < 0.0001). No correlation was found between the maximum AAA diameter and maximum iliac diameter, angulation, or length. CONCLUSIONS: AAA anatomy varies widely and independently of the aneurysm size. Therefore, the maximum size of the aneurysm is a poor predictor of whether or not an aneurysm is suitable for endovascular repair. The discrepancy between angiographic and axial CT measurements suggests that neither alone is sufficient as a preoperative imaging technique when evaluating a patient for an endovascular graft procedure.

KW - endovascular grafts

KW - aortic neck

KW - aneurysm diameter

KW - aneurysm length

KW - tortuosity

KW - angulation

U2 - 10.1583/1074-6218(1999)006<0227:AAAMIC>2.0.CO;2

DO - 10.1583/1074-6218(1999)006<0227:AAAMIC>2.0.CO;2

M3 - Article

VL - 6

SP - 227

EP - 232

JO - Journal of Endovascular Surgery

JF - Journal of Endovascular Surgery

SN - 1074-6218

IS - 3

ER -