Preoperative sizing of grafts for transfemoral endovascular aneurysm management: a prospective comparative study of spiral CT angiography, arteriography, and conventional CT imaging.
OBJECTIVE
To define the impact of spiral computed tomographic angiography (CTA) with image reconstruction on graft selection for Transfemoral Endovascular Aneurysm Management (TEAM) by comparing it to conventional computed tomography (CT) and contrast arteriography.


METHODS
Twenty-one candidates for TEAM were included. The diameters of the superior and inferior aneurysm necks and lengths between the graft attachment sites were measured using the three imaging techniques. These measurements and their consequences on graft selection were studied.


RESULTS
The difference in length sizing between spiral CTA and arteriography never exceeded 1 cm; however, lengths measured by conventional CT scanning resulted in underestimation of graft length in 91% of patients. Graft diameters were chosen too small in 62% of the patients when based on arteriographic diameter measurements. A graft of similar diameter was selected by spiral CTA and conventional CT scanning in 81% of the patients, while minor oversizing by conventional CT scanning was found in 14%.


CONCLUSIONS
Neither conventional CT scanning nor arteriography is adequate as a sole preoperative radiological investigation for TEAM graft sizing. Spiral CTA with image processing produces all information required for selection of the optimal graft size and should be regarded the method of first choice for this purpose.
Broeders
I A
IA
Department of Vascular Surgery, University Hospital Utrecht, The Netherlands.
Blankensteijn
J D
JD
Olree
M
M
Mali
W
W
Eikelboom
B C
BC
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D001807:Blood Vessel Prosthesis / Q000592:standards*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*