Endovascular repair of abdominal aortic aneurysm: Value of postoperative follow-up with helical CT

Alla Rozenblit, M. L. Marin, F. J. Veith, Jacob Cynamon, S. I. Wahl, C. W. Bakal

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

OBJECTIVE. Transfemorally placed endoluminal grafts are currently being evaluated as an alternative to open surgery for the treatment of abdominal aortic aneurysms. We determined the value of helical CT for the follow-up of patients treated with this new procedure. The purposes of this study were to determine CT features of a technically successful procedure, detect complications, and compare findings on CT scans obtained 24-48 hr after insertion of the graft with findings on angiograms obtained at the end of the endovascular procedure. SUBJECTS AND METHODS. Seven patients with large abdominal aortic aneurysms had helical CT within 48 hr after transfemoral insertion of an endoluminal graft. Findings on these CT scans were compared with findings on digital completion angiograms obtained immediately after placement of the graft. Additional follow-up CT scans were obtained for up to 15 months (mean, 8 months). The size of the aneurysmal sac; completeness of perigraft thrombosis; and position, shape, and patency of the device were recorded. RESULTS. CT scans obtained 24-48 hr after placement of the grafts showed complete thrombosis of the aneurysmal sac in three patients and incomplete thrombosis with patent perigraft channels in the four remaining patients. Angiograms showed a patent perigraft channel in only one patient. Two of four initially patent channels subsequently closed, but one of them recurred. Of four thrombosed aneurysms, two decreased in size, and two were unchanged on later follow-up. Of three aneurysms associated with perigraft channels, two became enlarged and one was stable. On the basis of CT criteria, successful endovascular repair was shown in four (57%) of seven patients. CONCLUSION. Helical CT is a sensitive means of evaluating the efficacy of endoluminal grafts. Decreased or stable size of the aneurysmal sac without perigraft channels on late follow-up CT signifies technical success. Persistence or recurrence of perigraft channels is the most likely cause of later enlargement of an aneurysm end therefore suggests procedural failure. Helical CT was more sensitive than angiography for detection of perigraft channels that occurred soon after treatment.

Original languageEnglish (US)
Pages (from-to)1473-1479
Number of pages7
JournalAmerican Journal of Roentgenology
Volume165
Issue number6
StatePublished - 1995

Fingerprint

Spiral Computed Tomography
Abdominal Aortic Aneurysm
Transplants
Angiography
Thrombosis
Aneurysm
Endovascular Procedures
Recurrence
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Rozenblit, A., Marin, M. L., Veith, F. J., Cynamon, J., Wahl, S. I., & Bakal, C. W. (1995). Endovascular repair of abdominal aortic aneurysm: Value of postoperative follow-up with helical CT. American Journal of Roentgenology, 165(6), 1473-1479.

Endovascular repair of abdominal aortic aneurysm : Value of postoperative follow-up with helical CT. / Rozenblit, Alla; Marin, M. L.; Veith, F. J.; Cynamon, Jacob; Wahl, S. I.; Bakal, C. W.

In: American Journal of Roentgenology, Vol. 165, No. 6, 1995, p. 1473-1479.

Research output: Contribution to journalArticle

Rozenblit, A, Marin, ML, Veith, FJ, Cynamon, J, Wahl, SI & Bakal, CW 1995, 'Endovascular repair of abdominal aortic aneurysm: Value of postoperative follow-up with helical CT', American Journal of Roentgenology, vol. 165, no. 6, pp. 1473-1479.
Rozenblit, Alla ; Marin, M. L. ; Veith, F. J. ; Cynamon, Jacob ; Wahl, S. I. ; Bakal, C. W. / Endovascular repair of abdominal aortic aneurysm : Value of postoperative follow-up with helical CT. In: American Journal of Roentgenology. 1995 ; Vol. 165, No. 6. pp. 1473-1479.
@article{f512abd9309046f499ac99a48b249348,
title = "Endovascular repair of abdominal aortic aneurysm: Value of postoperative follow-up with helical CT",
abstract = "OBJECTIVE. Transfemorally placed endoluminal grafts are currently being evaluated as an alternative to open surgery for the treatment of abdominal aortic aneurysms. We determined the value of helical CT for the follow-up of patients treated with this new procedure. The purposes of this study were to determine CT features of a technically successful procedure, detect complications, and compare findings on CT scans obtained 24-48 hr after insertion of the graft with findings on angiograms obtained at the end of the endovascular procedure. SUBJECTS AND METHODS. Seven patients with large abdominal aortic aneurysms had helical CT within 48 hr after transfemoral insertion of an endoluminal graft. Findings on these CT scans were compared with findings on digital completion angiograms obtained immediately after placement of the graft. Additional follow-up CT scans were obtained for up to 15 months (mean, 8 months). The size of the aneurysmal sac; completeness of perigraft thrombosis; and position, shape, and patency of the device were recorded. RESULTS. CT scans obtained 24-48 hr after placement of the grafts showed complete thrombosis of the aneurysmal sac in three patients and incomplete thrombosis with patent perigraft channels in the four remaining patients. Angiograms showed a patent perigraft channel in only one patient. Two of four initially patent channels subsequently closed, but one of them recurred. Of four thrombosed aneurysms, two decreased in size, and two were unchanged on later follow-up. Of three aneurysms associated with perigraft channels, two became enlarged and one was stable. On the basis of CT criteria, successful endovascular repair was shown in four (57{\%}) of seven patients. CONCLUSION. Helical CT is a sensitive means of evaluating the efficacy of endoluminal grafts. Decreased or stable size of the aneurysmal sac without perigraft channels on late follow-up CT signifies technical success. Persistence or recurrence of perigraft channels is the most likely cause of later enlargement of an aneurysm end therefore suggests procedural failure. Helical CT was more sensitive than angiography for detection of perigraft channels that occurred soon after treatment.",
author = "Alla Rozenblit and Marin, {M. L.} and Veith, {F. J.} and Jacob Cynamon and Wahl, {S. I.} and Bakal, {C. W.}",
year = "1995",
language = "English (US)",
volume = "165",
pages = "1473--1479",
journal = "American Journal of Roentgenology",
issn = "0361-803X",
publisher = "American Roentgen Ray Society",
number = "6",

}

TY - JOUR

T1 - Endovascular repair of abdominal aortic aneurysm

T2 - Value of postoperative follow-up with helical CT

AU - Rozenblit, Alla

AU - Marin, M. L.

AU - Veith, F. J.

AU - Cynamon, Jacob

AU - Wahl, S. I.

AU - Bakal, C. W.

PY - 1995

Y1 - 1995

N2 - OBJECTIVE. Transfemorally placed endoluminal grafts are currently being evaluated as an alternative to open surgery for the treatment of abdominal aortic aneurysms. We determined the value of helical CT for the follow-up of patients treated with this new procedure. The purposes of this study were to determine CT features of a technically successful procedure, detect complications, and compare findings on CT scans obtained 24-48 hr after insertion of the graft with findings on angiograms obtained at the end of the endovascular procedure. SUBJECTS AND METHODS. Seven patients with large abdominal aortic aneurysms had helical CT within 48 hr after transfemoral insertion of an endoluminal graft. Findings on these CT scans were compared with findings on digital completion angiograms obtained immediately after placement of the graft. Additional follow-up CT scans were obtained for up to 15 months (mean, 8 months). The size of the aneurysmal sac; completeness of perigraft thrombosis; and position, shape, and patency of the device were recorded. RESULTS. CT scans obtained 24-48 hr after placement of the grafts showed complete thrombosis of the aneurysmal sac in three patients and incomplete thrombosis with patent perigraft channels in the four remaining patients. Angiograms showed a patent perigraft channel in only one patient. Two of four initially patent channels subsequently closed, but one of them recurred. Of four thrombosed aneurysms, two decreased in size, and two were unchanged on later follow-up. Of three aneurysms associated with perigraft channels, two became enlarged and one was stable. On the basis of CT criteria, successful endovascular repair was shown in four (57%) of seven patients. CONCLUSION. Helical CT is a sensitive means of evaluating the efficacy of endoluminal grafts. Decreased or stable size of the aneurysmal sac without perigraft channels on late follow-up CT signifies technical success. Persistence or recurrence of perigraft channels is the most likely cause of later enlargement of an aneurysm end therefore suggests procedural failure. Helical CT was more sensitive than angiography for detection of perigraft channels that occurred soon after treatment.

AB - OBJECTIVE. Transfemorally placed endoluminal grafts are currently being evaluated as an alternative to open surgery for the treatment of abdominal aortic aneurysms. We determined the value of helical CT for the follow-up of patients treated with this new procedure. The purposes of this study were to determine CT features of a technically successful procedure, detect complications, and compare findings on CT scans obtained 24-48 hr after insertion of the graft with findings on angiograms obtained at the end of the endovascular procedure. SUBJECTS AND METHODS. Seven patients with large abdominal aortic aneurysms had helical CT within 48 hr after transfemoral insertion of an endoluminal graft. Findings on these CT scans were compared with findings on digital completion angiograms obtained immediately after placement of the graft. Additional follow-up CT scans were obtained for up to 15 months (mean, 8 months). The size of the aneurysmal sac; completeness of perigraft thrombosis; and position, shape, and patency of the device were recorded. RESULTS. CT scans obtained 24-48 hr after placement of the grafts showed complete thrombosis of the aneurysmal sac in three patients and incomplete thrombosis with patent perigraft channels in the four remaining patients. Angiograms showed a patent perigraft channel in only one patient. Two of four initially patent channels subsequently closed, but one of them recurred. Of four thrombosed aneurysms, two decreased in size, and two were unchanged on later follow-up. Of three aneurysms associated with perigraft channels, two became enlarged and one was stable. On the basis of CT criteria, successful endovascular repair was shown in four (57%) of seven patients. CONCLUSION. Helical CT is a sensitive means of evaluating the efficacy of endoluminal grafts. Decreased or stable size of the aneurysmal sac without perigraft channels on late follow-up CT signifies technical success. Persistence or recurrence of perigraft channels is the most likely cause of later enlargement of an aneurysm end therefore suggests procedural failure. Helical CT was more sensitive than angiography for detection of perigraft channels that occurred soon after treatment.

UR - http://www.scopus.com/inward/record.url?scp=0028845144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028845144&partnerID=8YFLogxK

M3 - Article

C2 - 7484590

AN - SCOPUS:0028845144

VL - 165

SP - 1473

EP - 1479

JO - American Journal of Roentgenology

JF - American Journal of Roentgenology

SN - 0361-803X

IS - 6

ER -