COMPLETE PREOPERATIVE IMAGING ASSESSMENT OF ABDOMINAL AORTIC-ANEURYSMWITH SPIRAL CT ANGIOGRAPHY

Purpose: A prospective evaluation of spiral CT angiography (SCTA) as t he sole preoperative imaging modality for abdominal aortic aneurysm re pair. Materials and methods: Spiral CT angiography was compared with c onventional transfemoral angiography in 30 patients and results correl ated with surgical findings in 22 patients. The following features wer e assessed: renal artery number and disease; upper and lower aneurysm extent; aneurysm size; perianeurysmal inflammation; iliac artery disea se; radiation dose; and contrast usage. Results: Spiral CT angiography agreed with conventional angiography in all cases of severe stenosis or occlusion of renal arteries and had 90% agreement overall for renal artery disease. Two of nine accessory renal arteries seen at conventi onal angiography were missed. For showing aneurysm extent SCTA was 100 % sensitive, and performed better than conventional angiography. Aneur ysm size was better shown with SCTA, In iliac disease SCTA, as perform ed in this study, was poor for mild-moderate disease, but detected fou r of six severely stenosed/occluded iliac arteries seen at conventiona l angiography. Prospective sensitivity for perianeurysmal inflammation was 33%. Radiation dose for SCTA was approximately twice and contrast dose approximately three times that for conventional angiography. Con clusion: Spiral CT angiography can provide all the necessary imaging i nformation to plan aneurysm repair in the non-claudicant.