ANATOMICAL SUITABILITY OF ABDOMINAL AORTIC-ANEURYSMS FOR ENDOVASCULARREPAIR

Background Aortic aneurysm anatomy is crucial when considering patient s for endovascular repair. The aim of this study was to determine the proportion of patients with aortic aneurysm suitable for endovascular repair with three different graft-stent systems. Methods Spiral comput ed tomographic angiography was used to assess the anatomy of 154 abdom inal aortic aneurysms. Measurements were made of aneurysm neck length and diameter, renal artery to aortic bifurcation length, common iliac artery diameter and length, and external iliac artery diameter. Aneury sms were assessed for anatomical suitability for currently available a ortoaortic, aortobi-iliac and aortouni-iliac devices. Results Six pati ents (4 per cent) had a distal aortic neck suitable for implantation o f a straight aortic graft. Fifteen patients (10 per cent) had arterial anatomy suitable for implantation of a bifurcated graft and 85 (55 pe r cent) patients were suitable for endovascular repair with an aortoun i-iliac graft. The primary reasons for unsuitability were: proximal ne ck length less than 1.5 cm (44 patients), proximal neck diameter great er than 3.0 cm (12), and angulation of the proximal neck (three). A fu rther ten patients were considered unsuitable for an aortouni-iliac gr aft because of bilateral common iliac artery aneurysms (four), tortuou s iliac arteries (four) and narrow external iliac arteries (two). Conc lusion The aortouni-iliac device has the widest applicability of the c urrently available endo vascular systems but open repair remains the o nly option for a large proportion of patients.