title: The benefits of EVAR planning using a 3D workstation.
abstract: OBJECTIVE
  To evaluate the influence of planning endovascular aneurysm repair (EVAR) with a three-dimensional (3D) workstation on early and midterm outcomes.
  
  
  METHODS
  All patients undergoing infrarenal EVAR performed between 2006 and 2009 at our institution were included in the current study. Prior to 2008 (group 1), endograft sizing was performed by interrogation of computed tomography angiography axial images. After 2008 (group 2), endograft sizing was routinely performed using a 3D workstation (Aquarius, Terarecon), allowing for multiplanar reconstruction and centerline analysis. Pre-, peri-, postoperative, and follow-up data were prospectively entered in an electronic database. All postoperative complications and subsequent secondary interventions depicted during the 2-year period following EVAR were compared. Secondary intervention and mortality rates were defined at 2 years and compared. Freedom from secondary intervention and overall survival rates were calculated using the Kaplan-Meier method during follow-up and compared by log-rank test.
  
  
  RESULTS
  A total of 295 patients (149 patients in group 1 and 146 patients in group 2) were included. All patients had completed a minimum of 2 years of follow-up. During this 2-year period following EVAR, the type 1 endoleak rate was 8.7% in group 1 and 1.4% in group 2 (p = .004) respectively. Secondary intervention rates related to type 1 endoleak was 5.4% in group 1 and 0 in group 2 (p < .001). No difference was observed regarding all-cause mortality, aneurysm-related death, and freedom from secondary intervention rates during follow-up.
  
  
  CONCLUSIONS
  The routine use of 3D workstations for EVAR planning significantly reduces the rate of type 1 endoleaks and, therefore, the rate of related secondary interventions.
authors: Vascular Center, Hôpital Cardiologique, Lille University Hospital, France.
authors: J
authors: J
authors: Sobocinski
authors: H
authors: H
authors: Chenorhokian
authors: B
authors: B
authors: Maurel
authors: M
authors: M
authors: Midulla
authors: A
authors: A
authors: Hertault
authors: M
authors: M
authors: Le Roux
authors: R
authors: R
authors: Azzaoui
authors: S
authors: S
authors: Haulon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D017076:Computer-Aided Design; D057867:Endoleak / Q000209:etiology / Q000517:prevention & control; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D004867:Equipment Design; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D053208:Kaplan-Meier Estimate; D008297:Male; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Endograft; Planning; Three-dimensional workstation