Aortic aneurysmal disease: Assessment of stent-graft treatment - CT versusconventional angiography

PURPOSE: To compare computed tomographic (CT) angiography and conventional angiography for determining the success of endoluminal stent-graft treatmen t of aortic aneurysms. MATERIALS AND METHODS: Forty patients underwent conventional angiography an d CT angiography following treatment of aortoiliac aneurysms with endolumin al stent-grafts. Six additional sets of conventional angiographic-CT angiog raphic examinations were performed in five patients after placement of addi tional stent-grafts or coil embolization to treat perigraft leakage. Three faculty CT radiologists who were blinded to patient clinical data and outco me independently interpreted the CT angiograms, and three faculty angiograp hers, who were not involved in the stent-graft deployment, interpreted the conventional angiograms. Images were assessed for the presence of postdeplo yment complications. A reference standard was developed by experienced radi ologists using all available images and clinical data. Sensitivities, speci ficities, and kappa values were calculated. RESULTS: Perigraft leakage was the most commonly identified complication. T wenty perigraft leaks were detected in the results of 46 examinations. Sens itivities and specificities for detecting perigraft leakage were 63% and 77 % for conventional angiography and 92% and 90% for CT angiography, respecti vely. The kappa value was 0.41 for conventional angiography and 0.81 for CT angiography. CONCLUSION: CT angiography is the preferred method for establishing the pre sence of perigraft leakage following treatment of aortoiliac aneurysms with stent-grafts.