Vasc Spec Int.  2017 Mar;33(1):27-32. 10.5758/vsi.2017.33.1.27.

Measuring of Abdominal Aortic Aneurysm with Three-Dimensional Computed Tomography Reconstruction before Endovascular Aortic Aneurysm Repair

Affiliations
  • 1Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. jhjoh@khu.ac.kr

Abstract

PURPOSE
Conventional computed tomography (CT) is the gold standard method for case planning for endovascular aortic aneurysm repair (EVAR). However, aortography with a marking catheter is needed for measuring the actual length of an aneurysm. With advances in imaging technology, a 3-dimensional (3D) workstation can obviate the need for the aortography. The objective of this study was to determine whether a 3D workstation could obviate the need for aortography for EVAR.
MATERIALS AND METHODS
One vascular surgeon and 1 interventional radiologist retrospectively assessed axial CT scans and reformatted the 3D CT scans by using the iNtuition workstation (TeraRecon Inc., San Mateo, CA, USA) for 25 patients who underwent EVAR. Four measurements of diameter and length were obtained from each modality. The actual length of an aneurysm for the proper graft was decided by 2 observers by reviewing the aortography with a marking catheter.
RESULTS
The measurements from the 2 modalities were reproducible with intraobserver correlation coefficients of 0.89 to 1.0 for conventional CT and 0.98 to 1.0 for 3D workstation. Interobserver correlation coefficients were 0.29 to 0.95 for conventional CT and 0.85 to 0.99 for the 3D workstation. The length of the aneurysm for proper main graft coincided in 18 and 14 patients according to the conventional CT scan and in 21 and 18 patients according to the 3D workstation, respectively.
CONCLUSION
The interobserver agreement in planning EVAR was significantly better with the iNtuition 3D workstation. But aortography with a marking catheter may still be needed for selecting the proper graft.

Keyword

Aortic aneurysm; Abdominal; Endovascular procedures; Aortography

MeSH Terms

Aneurysm
Aortic Aneurysm*
Aortic Aneurysm, Abdominal*
Aortography
Catheters
Endovascular Procedures
Humans
Intuition
Methods
Retrospective Studies
Tomography, X-Ray Computed
Transplants
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