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Abdominal aortic aneurysm neck morphology: proposed classification system

C O McDonnell¹, M Halak, A Bartlett

¹Dept of Vascular Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia. comcdonnell@eircom.net

Irish Journal of Medical Science

|November 1, 2006

Abstract

Background:

While aneurysm neck length, angulation and width have all been previously assessed in endovascular abdominal aortic aneurysm repair (EVAR), aneurysm neck shape has not been considered.

Aims:

To analyse the influence of aneurysm neck morphology on outcome following EVAR.

Methods:

Aneurysm neck morphology in 70 patients undergoing EVAR from April 2001 to May 2004 was determined using pre-operative CT scans and graft plans. Necks were classified as flared, parallel, irregular, conical, barrel or hourglass. End-points were death,Type I endoleak and graft migration.

Results:

Forty-six per cent of necks were flared, 34% parallel, 9% irregular, 6% conical, 3% barrel and 3% hourglass. Mean follow-up was 20.2 months (range 4-35). There was one Type I endoleak and one graft migration. There were no aneurysm related deaths.

Conclusions:

Assessment of aneurysm neck morphology should be part of the routine preoperative workup for EVAR. A classification system of AAA necks is suggested to facilitate this.

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