A simple technique to improve the accuracy of proximal AAA endograft deployment

Purpose: To report a technique for overcoming the positioning errors caused by angulation and rotation of the proximal aortic neck when anteroposterio r fluoroscopic imaging is used during endograft deployment. Technique: Aortic neck angulation and rotation were measured preoperatively using spiral computed tomographic angiography in sagittal and axial projec tions. Before proximal graft deployment, the proximal end of the endograft was centered in the field of view, and the position of the C-arm was adjust ed to the aortic neck angulation. Using this technique, optimal positioning of the endograft relative to the true position of the renal arteries can b e achieved. Condusions: C-arm angulation and rotation is helpful in facilitating perfec t positioning for an optimal seal between the endograft and the infrarenal aortic neck.