Evaluation ofaortic aneurysims with multi-dedector ct angiography in the follow-up of endovascular stent-graft repair

Purpose: The purpose of this study was to investigate the efficiency of MDCT angiography in evaluating stent-graft patency, relation of stent-graft with aorta and its visceral branches, position and migration, aneurysm sac changes and endoleak in the follow up after endovascular stent-greft repair.Materials and Methods: 14 patients who underwent endovascular stent-graft repair, between January 2005 ? December 2008, due to aortic diseases (11 aortic aneurysm and three dissection) aged between 51-78 years (mean: 66 years) were included in this study.MPR, CPR, MIP and VR images, in addition to axial images, were reconstructed from the whole data of the MDCT angiography examination. Stent-graft patency, its relation with aorta and its visceral branches, aneurysm diameter and possible complications were evaluated by using those image display methods.Results: In two of 11 patients who underwent stent-graft repair due to AAA, aneurysmal sac maximum diameter decreased significantly, there was minimal increase in diameter in four patients and no difference in other five. Three patients had type II and two patients had type I endoleak. Stent-graft migration was observed in three patient, parietal graft thrombosis in two patients, kinking in four patients and collapse in one patient.Structural changes such as stent-graft patency, migration and kinking and relsation of stent-graft with arta and its visceral branch relation were evaluated best by MIP images. Endoleak and graft thrombosis were visualized best in axial and MPR images. VR display method was useful in evaluating structural changes and relation of stent-graft with visceral branches. CPR images were valuable to demonstrate stent-graft thrombosis and stent-graft collapse.Conclusion: Our experience suggests that MDCT angiography is a non-invasive, effective surveillance method in evaluating stent-graft patency, relation of stent-graft with aorta and its visceral branches, position and migration, aneurysm sac changes and endoleak after endovascular stent-graft repair.