Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Hu, David; Pisimisis, George; Sheth, Rahul A.

doi:10.21037/cdt.2018.01.01

Cited by 7 publications

(3 citation statements)

References 57 publications

(75 reference statements)

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“…Exact assessment of anatomical and morphological attributes by pre-operative CT or MR angiography is crucial to ensure the best possible outcome [ 288 ]. With both OSR and EVAR, due care has to be exercised with regard to branch vessels to ensure adequate blood flow in renal, superior mesenteric, lumbar, and internal iliac supply zones to prevent postoperative sexual dysfunction and ischemic complications caused by inadequate pelvic circulation [ 289 , 290 , 291 ].…”

Section: Diagnosis and Managementmentioning

confidence: 99%

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

et al. 2022

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Despite declining incidence and mortality rates in many countries, the abdominal aortic aneurysm (AAA) continues to represent a life-threatening cardiovascular condition with an overall prevalence of about 2–3% in the industrialized world. While the risk of AAA development is considerably higher for men of advanced age with a history of smoking, screening programs serve to detect the often asymptomatic condition and prevent aortic rupture with an associated death rate of up to 80%. This review summarizes the current knowledge on identified risk factors, the multifactorial process of pathogenesis, as well as the latest advances in medical treatment and surgical repair to provide a perspective for AAA management.

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Section: Diagnosis and Managementmentioning

confidence: 99%

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

et al. 2022

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“…Each device used has differing fixation strategies depending on the aortic anatomy being assessed (see Table 2 and Figures 1,2) (24,25). Stent fixation can occur both There was a focus on "recent" studies (published from 2010 onwards) that directly compared SRF and IRF…”

Section: Endovascular Repair and Endograft Fixationmentioning

confidence: 99%

Renal outcomes of suprarenal vs. infrarenal endograft fixation in endovascular abdominal aortic aneurysm repair: a narrative review

Geragotellis¹,

Cox²,

Yip³

et al. 2022

Cardiovasc Diagn Ther

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Background and Objective: Abdominal aortic aneurysm (AAA) is a common pathology with a prevalence of 4.8%. AAA rupture is associated with significant mortality and so early diagnosis followed by regular monitoring is needed until treatment might be considered and plan intervention. Endovascular aneurysm repair (EVAR) is an established and effective alternative to open surgical repair (OSR) in the treatment of AAAs. Key parameters in defining conventional EVAR suitability include the infrarenal neck length and angulation for the fixation of the proximal graft component. Endograft fixation can be either suprarenal or infrarenal and much debate exists as to which approach is associated with optimum renal outcomes. This study aims to review the current literature with respect to the renal outcomes associated with conventional EVAR using suprarenal fixation (SRF) vs. infrarenal fixation (IRF).Methods: A search was conducted from major search indices (PubMed, Google Scholar and EMBASE) to identify relevant literature pertaining to renal outcomes in EVAR. Recent papers comparing SRF and IRF were evaluated and their findings discussed.

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“…Additionally, CTA of the abdomen is the standard of reference for pre-interventional planning of complex vascular procedures such as endovascular aortic repair (EVAR) or fenestrated EVAR (FEVAR) [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Optimizing Arterial Vessel Contrast in Portal Venous Phase with Virtual Monoenergetic Images from Photon-Counting Detector CT Scans of the Abdomen—First Clinical Experiences

Dillinger,

Overhoff,

Ayx

et al. 2024

Diagnostics

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Background: Photon-counting detector (PCD) computed tomography (CT) allows for the reconstruction of virtual monoenergetic images (VMI) at different thresholds. Objective: The aim of our study was to evaluate the optimal arterial contrast in portal venous (pv) scans regarding objective parameters and subjective image quality for different virtual keV levels. Methods: We identified 40 patients that underwent a CT scan with an arterial and pv phase on a PCD-CT (NAEOTOM alpha, Siemens Healthineers, Forchheim, Germany). The attenuation of abdominal arteries on pv phases was measured for different virtual keV levels in a monoenergetic+ application profile and for polychromatic (pc) arterial images. Two independent readers assessed subjective image quality, including vascular contrast in pv scans at different energy levels. Additionally, signal- and contrast-to-noise ratios (SNR and CNR) were measured. Results: Our results showed increasing arterial attenuation levels with decreasing energy levels in virtual monoenergetic imaging on pv scans with the highest attenuation at 40 keV, significantly higher than in the pc arterial phase (439 ± 97 HU vs. 360 ± 97, p < 0.001). Noise, SNR, and CNR were worse at this energy level (p < 0.001). Pv VMI showed less noise at energy levels above 70 keV (all p < 0.001). Subjective image quality was rated best at 70 keV, vascular contrast was best at 40 keV. Conclusions: Our research suggests that virtual monoenergetic images at 40 keV in Mono+ mode derived from a PCD-CT can be a feasible alternative to a true arterial phase for assessment of vessels with worse CNR and SNR.

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Repair of abdominal aortic aneurysms: preoperative imaging and evaluation

Cited by 7 publications

References 57 publications

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

Renal outcomes of suprarenal vs. infrarenal endograft fixation in endovascular abdominal aortic aneurysm repair: a narrative review

Optimizing Arterial Vessel Contrast in Portal Venous Phase with Virtual Monoenergetic Images from Photon-Counting Detector CT Scans of the Abdomen—First Clinical Experiences

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