The role of anatomic factors in predicting success of endovascular repair of thoracic aortic aneurysms.
OBJECTIVE
We evaluated the results of thoracic endovascular aneurysm repair (TEVAR) to determine what anatomic factors influenced the clinical outcomes.


METHODS
Preoperative computed tomography (CT) angiograms of 65 patients who underwent TEVAR were analyzed using 3-dimensional imaging. The proximal and distal neck, thoracic aneurysm, and iliac arteries were measured for angulation, diameter, length, calcification, and tortuosity. Immediate technical success and clinical success were measured.


RESULTS
Immediate technical success was achieved in 91% (59 of 65) of the patients analyzed. One patient died in the operating room during treatment of rupture. Clinical success was achieved in 83% (54 of 65) of patients at follow-up. Four patients had small endoleaks with no sac enlargement at follow-up. One patient was converted to open repair. Severe iliac calcification was found to be significant for deployment failure. The mean follow-up is 8 months (1-36 months).


CONCLUSIONS
Increased iliac calcification and increased iliac tortuosity correlate with an inability to successfully deploy the device.
Bowman
Jonathan N
JN
Division of Vascular Surgery, Mount Sinai School of Medicine, New York, USA. jonathan.bowman@mssm.edu
Silverberg
Daniel
D
Ellozy
Sharif
S
Teodorescu
Victoria
V
Poblete
Honesto
H
Marin
Michael
M
Faries
Peter
P
D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D002114:Calcinosis / Q000000981:diagnostic imaging; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D021621:Imaging, Three-Dimensional; D011237:Predictive Value of Tests; D011475:Prosthesis Failure; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome