Helical CT angiography of stent-grafts in abdominal aortic aneurysms: morphologic changes and complications.
Transfemoral placement of an endovascular stent-graft is increasingly be-ing used as an alternative to surgical repair in the treatment of abdominal aortic aneurysm, especially in high-risk patients. However, complications frequently occur after stent-graft placement. Helical computed tomographic (CT) angiography is a fast, minimally invasive procedure that is quickly becoming the imaging modality of choice for assessment of these complications. Thirty-nine patients who were treated for abdominal aortic aneurysm with stent-graft placement underwent helical CT angiography at routinely scheduled follow-up intervals or whenever complications were suspected. The resulting images were evaluated for the presence, extent, and origin of endovascular leaks. In addition, the position, shape, and patency of the stent-grafts were assessed. Findings included both graft-related (n = 4) and non-graft-related (n = 3) leaks, thrombosis of a graft limb (n = 3), distal migration of the stent-graft (n = 5), angulation of bifurcated stent-grafts distal to the main graft (n = 6), shrinkage of the abdominal aortic aneurysm (n = 7), enlargement of the aneurysm with secondary graft-related leaks (n = 2), and an aortoduodenal fistula (n = 1). Helical CT angiography can depict complications that develop after treatment of abdominal aortic aneurysms with endovascular stent-grafts. Long-term follow-up is required to determine the full spectrum and frequency of complications that may develop after initially successful repair.
Tillich
M
M
Department of Radiology, Karl-Franzens Medical School and University Hospital, Graz, Austria.
Hausegger
K A
KA
Tiesenhausen
K
K
Tauss
J
J
Groell
R
R
Szolar
D H
DH
D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001018:Aortic Diseases / Q000209:etiology; D001027:Aortography / Q000379:methods*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004378:Duodenal Diseases / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007412:Intestinal Fistula / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011475:Prosthesis Failure; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016157:Vascular Fistula / Q000209:etiology; D014654:Vascular Patency