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

Resch, Tim LU ; Ivancev, Krassi LU ; Lindh, Mats LU ; Nirhov, Nikolaj LU ; Nyman, Ulf LU and Lindblad, Bengt LU (1999) In Journal of Endovascular Surgery 6(3). p.227-232
Abstract
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endovascular grafts, aortic neck, aneurysm diameter, aneurysm length, tortuosity, angulation
in
Journal of Endovascular Surgery
volume
6
issue
3
pages
227 - 232
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:10495149
  • scopus:0032887289
ISSN
1074-6218
DOI
10.1583/1074-6218(1999)006<0227:AAAMIC>2.0.CO;2
language
English
LU publication?
yes
id
e444a3c3-3215-49ac-9782-09c6db451f14 (old id 1115661)
date added to LUP
2008-07-08 11:10:47
date last changed
2017-01-01 07:16:26
@article{e444a3c3-3215-49ac-9782-09c6db451f14,
  abstract     = {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 &lt; 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 &lt; 0.0001). There was a positive correlation between the maximum AAA diameter and the AAA length (r = 0.49, p &lt; 0.0001) and an inverse relationship between the neck length and the neck diameter (r = -0.36, p &lt; 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.},
  author       = {Resch, Tim and Ivancev, Krassi and Lindh, Mats and Nirhov, Nikolaj and Nyman, Ulf and Lindblad, Bengt},
  issn         = {1074-6218},
  keyword      = {endovascular grafts,aortic neck,aneurysm diameter,aneurysm length,tortuosity,angulation},
  language     = {eng},
  number       = {3},
  pages        = {227--232},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Surgery},
  title        = {Abdominal aortic aneurysm morphology in candidates for endovascular repair evaluated with spiral computed tomography and digital subtraction angiography},
  url          = {http://dx.doi.org/10.1583/1074-6218(1999)006<0227:AAAMIC>2.0.CO;2},
  volume       = {6},
  year         = {1999},
}