M. Krauss et al., IMAGING OF AORTIC STENT GRAFTS AND THEIR COMPLICATIONS, RoFo. Fortschritte auf dem Gebiete der Rontgenstrahlen und der neuenbildgebenden Verfahren, 169(4), 1998, pp. 388-396
Citations number
26
Categorie Soggetti
Radiology,Nuclear Medicine & Medical Imaging
Journal title
RoFo. Fortschritte auf dem Gebiete der Rontgenstrahlen und der neuenbildgebenden Verfahren
Purpose: To determine the optimal postoperative imaging modality for t
he follow-up of patients with endoluminal aortic stent grafts, Materia
l and Methods: From August 1994 to November 1997 214 patients (194 mal
e and 20 female) with abdominal and thoracic aortic aneurysms were tre
ated with endovascular stent grafts. 137 patients (129 male, 8 female)
with 89 tube grafts and 48 bifurcated grafts (45 EVT, 88 Stentor/Vang
uard. 3 Chuter, 1 Talent) were evaluated with contrast-enhanced spiral
-CT, duplex ultrasound, and DSA at a mean follow-up of 11.1 months. Re
sults: We found 12 persistent primary endoleaks (8.8%), 17 secondary e
ndoleaks (12.4%), 8 limb occlusions (5.8%), 28 endoluminal thrombi lin
ing the stent graft (20.4%), and 26 suture breakages of the stent fram
e (19%). in 9 patients (6.6%) the proximal end of the stent partially
covered the renal arteries. In 3 patients (2.2%) a partial renal infar
ction was seen. Spiral-CT was able to demonstrate all the above change
s except for 3 sidebranch endoleaks that were documented by duplex ult
rasound only and 8 suture breaks seen on abdominal plain Films only. T
he median aneurysm diameter decreased from 48 mm pre-operatively to 46
mm at 24 months post-operatively in patients with endoleaks and from
44 mm to 36 mm in patients without endoleak. For several patients the
decreasing aneurysm diameter did not reliably correlate with complete
exclusion of the aneurysm. Conclusion: For follow-up of endoluminal ao
rtic stent grafts contrast-enhanced spiral-CT is superior to duplex ul
trasound. DSA is necessary only for patients with complications requir
ing a secondary intervention.