title: Aortic-neck dilation after endovascular abdominal aortic aneurysm repair (EVAR): can it be predicted?
abstract: OBJECTIVE
  This study was performed to evaluate whether dynamic computed tomography (CT) can provide functional vessel information predicting outcomes of aortic neck in patients undergoing endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm (AAA).
  
  
  METHODS
  Twenty patients with and 20 without AAA were enrolled. Electrocardiographically (ECG)-gated data sets were acquired with a 64-slice CT scanner. Axial pulsatility measurements were taken at three levels: 2 cm above the highest renal artery; immediately below the lowest renal artery; 1 cm below the lowest renal artery. Three independent readers performed the measurements. Systolic and diastolic blood pressures were measured in the brachial artery to calculate arterial-wall distensibility expressed as pressure strain elastic modulus (Ep). Cross-sectional area change, wall distensibility and Ep value were statistically compared.
  
  
  RESULTS
  No significant differences were found in terms of Ep values in the suprarenal and juxtarenal level. In the AAA group, a significantly higher value was obtained at the infrarenal level. A subgroup of patients with AAA (45%) had a significantly higher Ep value at the infrarenal level.
  
  
  CONCLUSIONS
  Dynamic CT provided insight into the abdominal aorta pathophysiology. Identifying patients with higher infrarenal distensibility could change selection of graft size to improve proximal fixation.
authors.affiliation: Department of Bioimaging and Radiological Sciences, Institute of Radiology, A. Gemelli Hospital, Catholic University, L.go A. Gemelli 8, 00168, Rome, Italy. roberto.iezzi@rm.unicatt.it
authors.forename: R
authors.initials: R
authors.lastname: Iezzi
authors.forename: M
authors.initials: M
authors.lastname: Santoro
authors.forename: G
authors.initials: G
authors.lastname: Di Natale
authors.forename: F
authors.initials: F
authors.lastname: Pirro
authors.forename: R
authors.initials: R
authors.lastname: Dattesi
authors.forename: M
authors.initials: M
authors.lastname: Nestola
authors.forename: F
authors.initials: F
authors.lastname: Snider
authors.forename: L
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003287:Contrast Media; D057510:Endovascular Procedures; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging; D006801:Humans; D007479:Iopamidol / Q000031:analogs & derivatives; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012077:Renal Artery / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; C057937:iomeprol; D007479:Iopamidol
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