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Semin intervent Radiol 2009; 26(1): 044-055
DOI: 10.1055/s-0029-1208383
© Thieme Medical Publishers

Preprocedural Planning for Endovascular Stent-Graft Placement

Gregory Kicska1 , Harold Litt1
  • 1Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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Publikationsdatum:
16. März 2009 (online)

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ABSTRACT

Endovascular stent grafts have become a viable treatment for aortic thoracic and abdominal aneurysms in both elective and emergent situations. Computed tomographic (CT) angiography is the primary tool for determining eligibility for this procedure. This article discuses the preprocedural evaluation of an endovascular stent candidate. Evaluation begins with identification of the aneurysm pathology and its relationship to treatment efficacy. The radiologist must evaluate the aneurysm geometry for compatibility with stent hardware. Aneurysm features that suggest a contraindication must be recognized. Procedures that involve a combination of endovascular stenting and surgical revascularization are discussed so that the reader understands the limits of stent eligibility. Vascular access for stent placement must also be evaluated for the ability to accommodate stent delivery. The radiologist also must be familiar with CT imaging protocols and alternative methods of imaging that can evaluate stent feasibility. The utility of three-dimensional processing is discussed.

KEYWORDS

Aortic aneurysm - vascular surgical procedures - X-ray computed tomography - preoperative care - patient selection

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Harold LittM.D. Ph.D. 

Department of Radiology, University of Pennsylvania School of Medicine

3400 Spruce Street, Philadelphia, PA 19104

eMail: harold.litt@uphs.upenn.edu