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Related Experiment Videos

A new "angle" on aortic neck angulation measurement.

Mark Rockley1, Adnan Hadziomerovic1, Carl van Walraven2

  • 1Division of Vascular Surgery, University of Ottawa, Ottawa, Ontario, Canada.

Journal of Vascular Surgery
|March 7, 2019
PubMed
Summary
This summary is machine-generated.

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A new trigonometric formula accurately estimates aortic neck angulation using 2D CT views, improving upon standard measurements and reducing false negatives for severe angles in endovascular repair planning.

Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Infrarenal aortic neck angulation is a key predictor of endovascular aneurysm repair (EVAR) failure.
  • Traditional 2D CT measurements often inaccurately estimate true aortic neck angulation, especially with oblique angulation.
  • Three-dimensional (3D) reconstruction is the gold standard but may not always be accessible.

Purpose of the Study:

  • To compare a novel trigonometric paired angle formula with 3D centerline measurements for estimating true aortic neck angulation.
  • To assess the accuracy and reliability of the paired angle formula in clinical practice.

Main Methods:

  • Fifty patients undergoing EVAR were retrospectively studied.
  • 3D centerline measurements were performed by a radiologist.
Keywords:
Abdominal aortic aneurysmAngulationEndovascular aneurysm repairInstructions for use

Related Experiment Videos

  • A vascular surgeon, resident, and student applied the paired angle formula using 2D coronal and sagittal CT views.

    • Main Results:

    • The paired angle formula showed strong correlation with 3D measurements (ICC 0.74-0.87), comparable to intraobserver variability.
    • Estimates using the formula deviated minimally from 3D measurements (mean difference 6 degrees) without systemic bias.
    • The formula significantly reduced the false-negative rate for detecting severe angulation (>60 degrees) from 4.8% to 0.7% (P = .032), with a negative predictive value >99%.

    Conclusions:

    • The paired angle formula accurately estimates true aortic neck angulation and effectively rules out severe angulation compared to 3D measurements.
    • This method is a valuable adjunct for aortic neck angulation measurement, particularly when 3D software is unavailable.
    • Accurate angle measurement is crucial not only in vascular surgery but also in other specialties relying on preoperative measurements.