Value of angiography in the management of abdominal aortic aneurysm

Abstract

The value of angiography in the management of abdominal aortic aneurysms (AAA) was assessed in 100 consecutive patients with AAA. Angiographic information influenced management decisons and/or surgery performance in 75: In 23 patients at high risk for surgery because of associated medical problems, it helped in deferring surgery; in 52 patients it resulted in a change of operation from a standard aneurysm resection with conventional grafting to a more conservative procedure (three patients), more extensive grafting (45 patients) and/or the addition of other vascular reconstructions (32 patients). Angiography is considered an integral step in the routine preoperative workup of AAA and is particularly valuable for the determination of important anatomic details about the aneurysm (upper and lower extensions, relation to the renal arteries), the detection of associated vascular disease (of renal, visceral, pelvic and peripheral arteries), and the demonstration of aberrant renal arteries and collateral visceral circulation. Catheter techniques are considered most suitable and safe for examination of AAA.

Der Einsatz bildgebender Verfahren beim abdominellen Aortenaneurysma

“…5 French-Katheter) sowie der Ent wicklung nicht-ionischer, nieder-osmolarer Kontrast mittel relativiert werden. So konnten in größeren Stati stiken untersuchungsspezifische Komplikationen (Dis sektionen, Embolisationen, Blutungen) praktisch ver nachlässigt werden [26,31,32]. …”

Comparison of NMR imaging and aortography for preoperative evaluation of abdominal aortic aneurysm

“…Noninvasive studies used to delineate aortic anatomy include ultrasound (US) and computerized tomography (CT). These techniques accurately determine aneurysmal diameter, identify thrombus, and locate the caudal extent of the aneurysm relative to the iliac arteries (I, 2,[4][5][6][7][8][9][10][11][12][13]. Although US is the first prodecure used to verify the clinical diagnosis of AAA, it does have some limitations: renal arteries can be identified in only 7% of cases, their relationship to the cranial end of the aneurysm can be determined in only 40% of cases, and a leaking aneurysm may be camouflaged by intestinal gas.…”