Intra-operative computed tomography in endovascular aneurysm repair.
CONCLUSIONS: The current body of evidence suggests that intra-operative CT is superior to completion angiography at detecting clinically important EVAR complications and incurs a lower total radiation dose with no added risk of contrast-induced renal impairment. Further research directly comparing the two modalities in the same cohort is required to determine sensitivity for individual complications. PMID: 31904305 [PubMed - as supplied by publisher]
CT angiography offers excellent anatomic detail necessary for vascular procedural planning including endovascular aneurysm repair (EVAR). However, patients with renal insufficiency are at risk for acute renal failure due to iodinated contrast administration. Catheter-directed CT angiography is a technique in which dilute iodinated contrast is injected into an intra-aortic pigtail catheter during the CT scan. The purpose of this study was to evaluate the safety and efficacy of this technique.
CONCLUSION: Emergency percutaneous endovascular repair is a less invasive and effective approach for the treatment of traumatic blunt aortic injuries. Long-term result remains to be further followed. PMID: 32057561 [PubMed - as supplied by publisher]
Abstract OBJECTIVE: The aim of this study was to evaluate aortic remodelling and associated complications in patients treated by thoracic endovascular aneurysm repair (TEVAR) for blunt traumatic aortic injuries (BTAI). METHODS: This was a retrospective, observational, multicentre study. Remodelling was considered as aortic diameter variations of>2 mm and distal graft and aortic axis angle modification measured by computed tomography angiography (CTA). The predefined levels of measurement were the proximal end of the graft (D1: landing in zone [LZ] 2; D2: LZ 3); distal end (D3); and control measurement...
The objective of this study was to evaluate the efficacy of treating type II endoleaks (T2Ls) after aortic endovascular repair with image guidance translumbar puncture using intraoperative cone beam computed tomography with preprocedure computed tomography angiography fusion in hybrid operating rooms.
Objectives The aim of this study was to compare image quality, conspicuity, and endoleak detection between single-energy low-kV images (SEIs) and dual-energy low-keV virtual monoenergetic images (VMIs+) in computed tomography angiography of the aorta after endovascular repair. Materials and Methods An abdominal aortic aneurysm phantom simulating 36 endoleaks (2 densities; diameters: 2, 4, and 6 mm) in a medium- and large-sized patient was used. Each size was scanned using single-energy at 80 kVp (A) and 100 kVp (B), and dual-energy at 80/Sn150kVp for the medium (C) and 90/Sn150kVp for the large size (D). VMIs+ at 40 k...
Introduction: Optimal visualization of target vessels in three-dimensions (3D) plays a key role in complex endovascular procedures, such as fenestrated and branched endovascular aortic repair (EVAR). A popular imaging technique to enhance target vessel visualization is image fusion. Image fusion combines real-time fluoroscopy with static preprocedural anatomical images, typically computed tomography angiography (CTA) to create an arterial roadmap. However, the introduction of stiff endovascular devices cause the arteries to stretch, leading to a mismatch between the actual position of the (origin of the) artery and its rep...
Introduction: Presence of gas is a frequent finding on early postoperative computed tomography angiography (CTA) after endovascular aortic aneurysm repair (EVAR) with unclear clinical relevance. The aim of this study was to examine and compare the presence of gas within the aneurysm sac following EVAR on early postoperative CTA after the use of carbon-dioxide (CO2) flushing technique with saline flushing alone.
Introduction: EVAR (Endo Vascular Aortic Repair) is the first line therapy for the treatment of abdominal aortic aneurysms (AAA). The most frequent post-operative complications of EVAR are endoleaks (EL) that occur when blood leaks back into the aneurysm sac. Type II EL is the most frequent complication requiring lifelong surveillance by radiological imaging. Nowadays, according to guidelines, Computed Tomography Angiography (CTA) scan represents the gold standard modality of imaging to detect EL.
Introduction: This is a study designed to assess the effectiveness of the new Angio PLanewave UltraSensitive imaging (Angio PL.U.S.) method as a non-invasive alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR). The authors emphasize the potential role of Angio PL.U.S. in patients undergoing post-EVAR follow-up.
ConclusionCombined endovascular aneurysm repair and on-pump beating heart coronary artery bypass grafting in a one-stage operation is a promising strategy to improve therapeutic efficiency in octogenarians. More studies are needed to compare the efficacy and safety of one-stage and two-stage operations to treat concomitant coronary artery disease and aortovascular pathology in the high-risk octogenarian patients.