Helical CT angiography of stent-grafts in abdominal aortic aneurysms: Morphologic changes and complications

Transfemoral placement of an endovascular stent-graft is increasingly being used as an alternative to surgical repair in the treatment of abdominal ao rtic aneurysm, especially in high-risk patients. However, complications fre quently occur after stent-graft placement. Helical computed tomographic (CT ) angiography is a fast, minimally invasive procedure that is quickly becom ing the imaging modality of choice for assessment of these com plications. Thirty-line patients who were treated for abdominal aortic aneurysm with st ent-graft placement underwent helical CT angiography at routinely scheduled follow-up intervals or whenever complications were suspected. The resultin g images were evaluated for the presence, extent, and origin of endovascula r leaks. In addition, the position, shape, and patency of the stent-grafts were assessed. Findings included both graft-related (n = 4) and non-graft-r elated (n = 3) leaks, thrombosis of a graft limb (n = 3), distal migration of the stent-graft (n = 5), angulation of bifurcated stent-grafts distal to the main graft (n = 6), shrinkage of the abdominal aortic aneurysm (n = 7) , enlargement of the aneurysm with secondary graft-related leaks (n = 2), a nd an aortoduodenal fistula (n = 1). Helical CT angiography can depict comp lications that develop after treatment of abdominal aortic aneurysms-with e ndovascular stent-grafts. Longterm follow-up is required to determine the f ull spectrum and frequency of complications that may develop after initiall y successful repair.