Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography.
OBJECTIVE
To compare computed tomographic (CT) angiography and conventional angiography for determining the success of endoluminal stent-graft treatment of aortic aneurysms.


METHODS
Forty patients underwent conventional angiography and CT angiography following treatment of aortoiliac aneurysms with endoluminal stent-grafts. Six additional sets of conventional angiographic-CT angiographic examinations were performed in five patients after placement of additional stent-grafts or coil embolization to treat perigraft leakage. Three faculty CT radiologists who were blinded to patient clinical data and outcome independently interpreted the CT angiograms, and three faculty angiographers, who were not involved in the stent-graft deployment, interpreted the conventional angiograms. Images were assessed for the presence of postdeployment complications. A reference standard was developed by experienced radiologists using all available images and clinical data. Sensitivities, specificities, and kappa values were calculated.


RESULTS
Perigraft leakage was the most commonly identified complication. Twenty perigraft leaks were detected in the results of 46 examinations. Sensitivities and specificities for detecting perigraft leakage were 63% and 77% for conventional angiography and 92% and 90% for CT angiography, respectively. The kappa value was 0. 41 for conventional angiography and 0.81 for CT angiography.


CONCLUSIONS
CT angiography is the preferred method for establishing the presence of perigraft leakage following treatment of aortoiliac aneurysms with stent-grafts.
Armerding
M D
MD
Department of Radiology, Stanford University School of Medicine, Stanford University Medical Center, Stanford, CA 94305-5105, USA.
Rubin
G D
GD
Beaulieu
C F
CF
Slonim
S M
SM
Olcott
E W
EW
Samuels
S L
SL
Jorgensen
M J
MJ
Semba
C P
CP
Jeffrey
R B
RB
Dake
M D
MD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000792:Angiography / Q000295:instrumentation / Q000379:methods; D015901:Angiography, Digital Subtraction / Q000379:methods; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000209:etiology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D016001:Confidence Intervals; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000295:instrumentation; D005260:Female; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013223:Statistics as Topic; D015607:Stents / Q000009:adverse effects; D014057:Tomography, X-Ray Computed / Q000379:methods; D014963:X-Ray Intensifying Screens
D003287:Contrast Media