AORTIC-ANEURYSM MORPHOLOGY FOR PLANNING ENDOVASCULAR AORTIC GRAFTS - LIMITATIONS OF CONVENTIONAL IMAGING METHODS

Purpose: To test whether conventional computed tomography scanning (CT ) and contrast aortography (CA) provide adequate data for planning end ovascular aortic grafting by measuring 33 parameters in patients havin g both imaging examinations for evaluation of abdominal aortic aneurys ms (AAA). Methods: Fifty consecutive patients with AAA (41 men, 9 wome n; average age 65 years) had CT and CA (mean 26 days between exams). T he data collected and analyzed included: 8 sites of diameter, 4 length s, 6 angles, and 15 other dimensional measurements. Results: Conflicts between CA and CT data were common. Eighteen patients appeared to hav e a distal cuff by CA but not by CT. Proximal neck length could not be assessed by CT in 5 and had a difference between CA and CT > 1 cm in 25 patients. CA overestimated neck length in 11 patients. Common iliac artery angulation > 60 degrees occurred unilaterally in 27 patients a nd bilaterally in 5. Seven patients had both iliac aneurysm and > 60 d egrees iliac angulation. Thirteen patients had one or more iliac aneur ysms (> 2 cm) shown by CT but not by CA. Conclusions: For endovascular graft planning: (1) more detailed measurement is required than for tr aditional surgery; and (2) conventional CT and CA are complementary im aging studies, but each has important limitations.