Document Detail


Virtual angioscopy and 3D navigation: a new technique for analysis of the aortic arch after vascular surgery.
MedLine Citation:
PMID:  20619704     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Anatomy of the aortic arch is highly variable and can be drastically altered by surgical or endovascular procedures. Detailed analysis of computed tomography (CT) scans is facilitated by reconstruction techniques such as virtual angioscopy (VA). In the present study, we have evaluated the benefit of VA for the assessment of aortic arch abnormalities in patients with prior surgical or endovascular procedures. MATERIAL AND METHODS: We analysed post-procedural CT scans available in 103 patients who underwent thoracic aortic procedures between 2006 and 2009 at our institution. Patients were classified into three groups: surgical (group A, n = 26), hybrid (group B, n = 27) and endovascular (group C, n = 50), procedures. A 64 LightSpeed volume computed tomography (VCT) multidetector-row computed tomography was used, allowing maximal intensity projection, maximal projection rendering imaging and three-dimensional (3D) rendering of images. VA reconstruction was performed by applying volume-rendered thresholds and spatial rendering to generate endoluminal views. RESULTS: Multiplanar reformations (MPRs) detected 46 abnormalities in 39 patients: inadequate apposition of the proximal rim of a stent-graft (n = 21), abnormalities of the stent-graft itself (n = 11), aortic aneurysm (n = 6), residual intimal tears (n = 5) and secondary dissection (n = 3). VA provided additional information in 76% of cases (35/46) and was more contributive after endovascular repair than after open repair (group A: 54% (7/14), group B: 75% (9/12), group C: 95% (19/20)). VA improved localisation of abnormalities with respect to supra-aortic vessels, measured inadequate stent-graft apposition in relation to the aortic wall and precisely analysed kinking or inadequate apposition of overlapping stent grafts. VA diagnosed three additional abnormalities: two false aneurysms and one retrograde dissection developed on a suture line. CONCLUSIONS: VA conceptualises planar images by 3D reconstruction. It provides additional information in comparison with conventional CT scans by allowing precise localisation of abnormalities with respect to the aortic wall itself and supra-aortic vessels. Furthermore, it facilitates analysis of abnormalities in case of overlapping stent grafts.
Authors:
N Louis; E Bruguiere; H Kobeiter; P Desgranges; E Allaire; M Kirsch; J P Becquemin
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Publication Detail:
Type:  Journal Article     Date:  2010-07-08
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  40     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  340-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Department of Vascular Surgery, Hopital Henri-Mondor, APHP, Faculte de Medecine Paris XII, 51 avenue du Maréchal de Lattre-de Tassigny, 94010 Creteil Cedex, France. kingnicofr@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioscopy*
Aorta, Thoracic / radiography*,  surgery*
Aortic Diseases / radiography*,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation
Female
Humans
Imaging, Three-Dimensional*
Male
Middle Aged
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted*
Reoperation
Retrospective Studies
Stents
Tomography, X-Ray Computed*
Treatment Outcome

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


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