Preprocedural planning for endovascular stent-graft placement

Area of Science:

• Vascular Surgery
• Radiology
• Medical Imaging

Background:

• Endovascular stent grafts offer a minimally invasive treatment for thoracic and abdominal aortic aneurysms.
• Computed tomographic (CT) angiography is the standard imaging modality for preprocedural assessment.

Purpose of the Study:

• To outline the comprehensive preprocedural evaluation process for endovascular stent graft candidates.
• To highlight the radiologist's role in determining suitability for endovascular aneurysm repair.

Main Methods:

• Review of CT angiography protocols and interpretation for aneurysm assessment.
• Evaluation of aneurysm pathology, geometry, and relationship to adjacent structures.
• Assessment of vascular access and consideration of hybrid endovascular and surgical approaches.

Main Results:

• Successful endovascular stent graft placement depends on accurate preprocedural evaluation.
• Identification of aneurysm features and patient anatomy critical for treatment success.
• Understanding limitations and contraindications for stent graft eligibility is essential.

Conclusions:

• A thorough radiologic evaluation using CT angiography is paramount for successful endovascular stent graft procedures.
• Radiologists play a key role in patient selection, optimizing outcomes for aortic aneurysm treatment.
• Familiarity with imaging techniques, including 3D processing, enhances the assessment of stent feasibility.