Post-endovascular aortic treatment evaluation under the era of MDCT-angiography

Congress:

ECR 2019

Poster Number:

C-3678

Type:

Educational Exhibit

Keywords:

Aneurysms, Computer Applications-Detection, diagnosis, Computer Applications-3D, Angioplasty, CT-Angiography, Computer applications, Cardiovascular system, Arteries / Aorta

Authors:

N. Lama¹, V. P. Patris¹, D. Fagrezos¹, V. Tsapaki², M. Smarda³, E. TSIPRA⁴, M. Argiriou¹, C. Triantopoulou¹, P. Maniatis¹; ¹Athens/GR, ²Nea Ionia/GR, ³Athens, GR/GR, ⁴Attiki, Attiki/GR

DOI:

10.26044/ecr2019/C-3678

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3678

Fig. 1: Volume rendered image after FEVAR (fenestrated endovascular aneurysm Repair).

Fig. 5: Hybrid endovascular repair, with the use of stent-graft and an Amplatzer...

Fig. 3: Volume rendered VRT and maximum intensity projection MIP images, demostrating a...

Fig. 4: Endoleak type IIIa

Fig. 9: Stent graft kincking and endoleak type Ia

Learning objectives

Οur goal is to annotate the value of knowledge of endovascular techniques and newly used devices, which enables the differentiation between expected post treatment findings and possible complications. The recognition and classification of diverse endoleaks, is the key finding in order to lead to proper management planning.

Background

An extensive and miscellaneous spectrum of diseases require aortic endovascular treatment, either in emergency need or as an elective procedure. The most important of them are dissections, intramural hematomas, aneurysms, penetrating ulcers, traumatic ruptures and pseudoaneurysm, or stenosis. CT angiography, represent a noninvasive and truly reliable method, for patient pre and post stent-graft assessment. Detailed anatomic evaluation is essential prior a TEVAR/EVAR method in order to properly plan the procedure and prevent possible complications. Also a sufficient post-procedural patient’s surveillance should be performed in order...

Findings and procedure details

We retrospectively overview, CT angiography studies performed during the previous year in our hospital, in order to review and describe normal and abnormal post procedural CT findings. All sellected patients had undergone aortic endovascular repair and underwent CT scan either during early or late postoperative period looking for complications, or in the basis of their yearly follow up. Most of our abnormal findings were in concordance with endoleaks, but also unexpected findings, which occurred on the basis of recently used stent-grafts or other endovascular devices....

Conclusion

Τhe promptly detection of the variety of pathological postoperative findings, after endovascular treatment procedures and the precise awareness of what these implications could reflect, can significant promote best patient’s management.

Personal information

References

Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management. Daye D1, Walker TG1. Cardiovasc Diagn Ther. 2018 Apr;8(Suppl 1):S138-S156. doi: 10.21037/cdt.2017.09.17 Essentials of endovascular abdominal aortic aneurysm repair imaging: postprocedure surveillance and complications. Picel AC1, Kansal N. AJR Am J Roentgenol. 2014 Oct;203(4):W358-72. doi: 10.2214/AJR.13.11736. Post-EVAR split-bolus CT angiography using dual-energy CT: all you need in a single scan! R. Iezzi1, F. Carchesio2, A. Posa2, C. Colosimo3, L. Bonomo4; 1Catholic University Rome/IT, 2 Roma/IT, 3Catholic University and School of Medicine...