Imaging Obtained Up To 12 Months Preoperatively Is Adequate for Planning Fenestrated/Branched Endovascular Aortic Aneurysm Repair
| Autor: | Allison S. Crawford, Sourav Podder, Jessica P. Simons, Dejah R. Judelson, Tammy T. Nguyen, Andres Schanzer, Edward J. Arous, Francesco A. Aiello |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Computed Tomography Angiography Computed tomography 030204 cardiovascular system & hematology Aortic repair Prosthesis Design Aortography 03 medical and health sciences Blood Vessel Prosthesis Implantation 0302 clinical medicine Predictive Value of Tests medicine Humans 030212 general & internal medicine Aged Retrospective Studies Observer Variation Aortic aneurysm repair medicine.diagnostic_test Aortic Aneurysm Thoracic business.industry Endovascular Procedures Reproducibility of Results General Medicine Blood Vessel Prosthesis Treatment Outcome Surgery Female Radiology Cardiology and Cardiovascular Medicine business Aortic Aneurysm Abdominal |
| Zdroj: | Vascular and endovascular surgery. 53(7) |
| ISSN: | 1938-9116 |
| Popis: | Objectives: Patients referred for fenestrated/branched endovascular aortic repair (F/BEVAR) often present with a previous computed tomography angiogram (CTA), but it is unknown how recent the CTA must be to ensure accurate F/BEVAR planning. We sought to determine whether anatomic planning parameters change significantly between a CTA used for F/BEVAR planning and a CTA obtained 6 to 12 months prior. Methods: Two blinded observers reviewed preoperative CTAs from 21 patients who underwent F/BEVAR. Each patient had a “recent” scan obtained 0 to 6 months before F/BEVAR planning and a “prior” scan obtained 6 to 12 months before the “recent” CTA. Standard measurements included (1) target vessel separation distances, (2) target vessel origin clock position, and (3) proximal F/BEVAR device diameter. Clinically significant differences for target vessel separation distance, target vessel origin clock position, and proximal F/BEVAR device diameter were predefined as >5 mm, >30 minutes, and >4 mm, respectively. Differences between “recent”/“prior” CTA scans were examined by paired t test. Results: Mean time interval between paired “recent”/“prior” CTAs was 8.0 months (standard deviation: ±1.7). Mean difference in paired “recent”/“prior” target vessel distance (relative to celiac artery [CA]) was 2.6 mm for the superior mesenteric artery (SMA), 2.5 mm for the right renal artery (RRA), and 3.3 mm for the left renal artery (LRA). Of the 21 paired “recent”/“prior” CTAs, clinically significant differences were observed in 2, 4, and 2 patients for SMA, RRA, and LRA target vessel distance, respectively. Target vessel clock position (SMA reference at 12:00) varied by 12 minutes for the CA, 13 minutes for the RRA, and 15 minutes for the LRA. One paired “recent”/“prior” CTA was found to have a clinically significant difference for the LRA. No clinically significant differences were observed for proximal device diameter. Conclusions: In patients who underwent successful F/BEVAR, measurement comparisons between CTAs obtained up to 1 year prior were minor and unlikely to yield clinically significant changes to F/BEVAR design. |
| Databáze: | OpenAIRE |
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