Document Detail


Validation of DynaCT in the morphological assessment of abdominal aortic aneurysm for endovascular repair.
MedLine Citation:
PMID:  20426634     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the feasibility of intraoperative 3-dimensional rotational angiography (DynaCT) as a single tool to assess suitability for endovascular aneurysm repair (EVAR) and for sizing the stent-graft. METHODS: Twenty elective patients undergoing EVAR were prospectively recruited. All had preoperative multidetector computed tomography (CT) scans and intraoperative (pre-stent deployment) DynaCT scans. Images were read independently by 4 experienced endovascular practitioners. A total of 17 morphological variables, including aneurysm neck diameter and length, were measured from the CT and DynaCT images and compared. Bland-Altman plots examined intraclass correlation of continuous outcomes; kappa correlation coefficient assessed agreement of ordinal results. RESULTS: The mean DynaCT radiation dose was 3751+/-835 microGym(2). The mean difference between DynaCT and multidetector CT in aneurysm neck diameter measurement was -1.5 mm (95% CI -4.9 to 1.9). Differences in left and right common iliac artery diameters were -1.9 mm (95% CI -6.3 to 2.4) and -2.1 mm (95% CI -6.9 to 2.7), respectively. For presence of neck thrombus, the group kappa statistic was 0.51 (p<0.0001); for neck calcification, the kappa was 0.07 (p = 0.29). Nine (45%) cases had incomplete information on DynaCT because external iliac arteries were not included in the scan. CONCLUSION: DynaCT provides adequate preoperative imaging for morphological assessment of aortic anatomy. The greatest limitation is the evaluation of access vessels and underestimation of calcification. Due to current limited detector size, precise positioning is essential to attain all necessary sizing information using DynaCT.
Authors:
Ian M Nordon; Robert J Hinchliffe; Amir H Malkawi; Jeremy Taylor; Peter J Holt; Robert Morgan; Ian M Loftus; Matt M Thompson
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Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-29     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  183-9     Citation Subset:  IM    
Affiliation:
St George's Vascular Institute, St George's Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty*
Aortic Aneurysm, Abdominal / radiography*,  therapy*
Aortography / methods*
Blood Vessel Prosthesis Implantation
Cohort Studies
Feasibility Studies
Female
Humans
Imaging, Three-Dimensional*
Male
Monitoring, Intraoperative
Observer Variation
Predictive Value of Tests
Reproducibility of Results
Tomography, X-Ray Computed*
Comments/Corrections
Comment In:
J Endovasc Ther. 2010 Apr;17(2):190-1   [PMID:  20426635 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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