Descending thoracic aortic aneurysm: thoracic CT findings after endovascular stent-graft placement.
OBJECTIVE
To evaluate the usefulness of thoracic computed tomography (CT) after placement of an endovascular stent-graft for the treatment of descending thoracic aortic aneurysm.


METHODS
From 1992 to 1996, 85 patients with thoracic aortic aneurysm underwent stent-graft placement. In 63 patients, thoracic CT scans were obtained both before and within 10 days after placement. The CT findings were retrospectively studied, and their clinical effect analyzed. In 20 of 63 patients, long-term follow-up CT findings were also evaluated.


RESULTS
After stent-graft placement in the 63 patients, CT demonstrated an increase in pleural effusion in 46 (73%), periaortic changes in 21 (33%), perigraft leak in 13 (21%), atelectasis in six (10%), mural thrombus within the stent-graft in two (3%), and new aortic dissection in one (2%). The mean maximum diameter of the aneurysm was 58.8 mm before and 60.0 mm after stent-graft insertion. Sixty-two (98%) patients were successfully treated until discharge. Interventional procedures were performed to eliminate the leakage into the aneurysm sac in 10 patients with perigraft flow depicted at CT. Other complications were managed conservatively.


CONCLUSIONS
Thoracic CT is useful in the treatment of patients after stent-graft insertion for the management of descending thoracic aortic aneurysm.
Department of Cardiovascular and Interventional Radiology, Stanford University Medical Center, CA 94305-1056, USA.
T
T
Sakai
M D
MD
Dake
C P
CP
Semba
T
T
Yamada
A
A
Arakawa
S T
ST
Kee
N
N
Hayashi
M K
MK
Razavi
D Y
DY
Sze
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D015607:Stents; D014057:Tomography, X-Ray Computed