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?
H. Kobeiter, 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?, J MAL VASC, 23(5), 1998, pp. 387-389
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.