Which investigations should be selected for the preoperative assessment ofan abdominal aortic aneurysm before deciding on treatment by endoprosthesis: arteriography, CT-scanning or magnetic resonance imaging?

Purpose. To determine the best imaging technique to obtain all the necessar y information before the placement of an aortic endoprosthesis. Method. Each technique is assessed from a review of the literature and the AA's own experience (21 endoprostheses); the advantages and disadvantages o f each technique are discussed. Results. 1) Arteriography (with a calibrated catheter), always considered a t the investigation of choice to determine the feasability of the technique , gives no information on the aortic wall; 2) spiral CT scanning is superior to basic scanning in giving a 3-dimension al picture. Many authors have concluded that spiral CT-scanning has replace d aortography. but its limitation, at the moment, is in the quality of the assessment of the renal arteries (number, stenosis); 3) magnetic resonance imaging has not been studied to any extent in terms o f assessment for endoprosthetic treatment. Early results are promising and will be described. Conclusions. At the present time, the best compromise is spiral-CT scanning in thin sections with 3-dimensional reconstruction. The AA combine this wi th arteriography to visualise the renal arteries in particular, and the dis tal bed.