Spiral CT angiography versus aortography in the assessment of aortoiliac length in patients undergoing endovascular abdominal aortic aneurysm repair.
OBJECTIVE
To compare measurements of aortoiliac length obtained with spiral computed tomographic angiography (CTA) and aortography in patients undergoing endovascular aneurysm repair.


METHODS
The distances from the lower-most renal artery to the aortic bifurcation and from the aortic bifurcation to the common iliac artery (CIA) bifurcation were measured using both CTA and aortography in 108 patients with abdominal aortic aneurysms.


RESULTS
The level of agreement between CTA and aortography was high, with 69% of aortic and 76% of iliac measurements within 1 cm and > 90% within 2 cm of each other. Mean differences were -0.35 +/- 1.20 cm and 0.25 +/- 1.10 cm, respectively, for aortic and iliac lengths. Aortography overestimated renal artery to aortic bifurcation length in comparison to CTA (p = 0.003), particularly in patients with large aneurysms (> 6.5 cm) and lumen diameters > 4.5 cm (p < 0.0001). Measurements of CIA length were shorter by aortography than CTA (p = 0.02).


CONCLUSIONS
There is a high level of agreement between CTA and aortography in the measurement of aortoiliac length, but aortography overestimates renal artery to aortic bifurcation length in patients with large-diameter aneurysms and wide aneurysm lumens. CTA is sufficiently accurate in the majority of cases to be used as the sole basis for the construction of endovascular grafts.
Department of Vascular and Endovascular Surgery, University Hospital, Nottingham, United Kingdom. mattarmon@compuserve.com
M P
MP
Armon
S C
SC
Whitaker
R H
RH
Gregson
P W
PW
Wenham
B R
BR
Hopkinson
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001807:Blood Vessel Prosthesis / Q000592:standards*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome