The place of abdominal aortography in abdominal aortic aneurysm resection

We analyzed 110 patients who underwent abdominal aortography as a routine preliminary to abdominal aortic aneurysm resection. In 11 of the 15 patients for whom the procedures were useful in planning the operative tactics, the aortograms would have been performed anyway on clinical indications. In two patients, the changes in surgical maneuvers would not have been made through anatomic inspection at the time of the operations, but the lesions were asymptomatic. Biplane views and views of the femoropopliteal systems were rarely influential. Morbidity from the angiography was minimal and mortality was zero, but about seven aortograms were performed for each one that effected a change in procedure. We concluded that abdominal aortography as a preliminary to aneurysmectomy could be reasonably limited to patients in whom it was indicated by clinical features, including important hypertension, impaired renal function, diminished or absent femoral pulses, suspected mesenteric ischemia, suspected suprarenal extension of the aneurysm, or suspected (from the chest roentgenograms) thoracic aneurysm.