Clinical application of 64 multi-slice CT angiography for the follow-up of endovascular stent-graft exclusion

Abstract

Objective To investigate the clinical applications of 64-MSCTA for the follow-up of endovascular stent-graft exclusion (EVE). Methods Between Oct 2006 and Feb 2008, forty-four 64-MSCTA examinations were performed in 30 patients with aortic dissection (AD) and 5 patients with abdominal aortic aneurysm (AAA) who underwent EVE. Imaging reconstruction including MPR, MIP and VR were finished on workstation. The outcomes and complications after EVE of aortic dissection and aortic aneurysm were evaluated. Results (1) Of 30 patients with aortic dissection, large thrombosis in false lumen was observed in 28 cases and small thrombosis in 2 cases. The cavity of aortic aneurysm outside the stent was thrombosed completely in 5 patients with AAA. (2) Thrombosis in the innominate artery on follow-up CTA after EVE was found in 1 AD patient with the innominate artery involved, Thrombosis in the superior mesenteric artery was observed on 15 days follow-up CTA but thrombolysis on 3 months after EVE in 1 case, lntimal tear in right common iliac artery was found in 1 case. Of 5 patients with AAA, occlusion of right inner iliac artery was observed in 1 case, and instent thrombosis in distal right common iliac artery was found in 1 case. (3) Endoleak was found in 14 patients with AD, including 8 with type Ⅰ and 6 with type Ⅲ endoleaks, one type Ⅲ endoleak was disappeared on follow-up CTA after 3 months. Conclusions 64-MSCTA with fast, non-invasive and effective merits, combining multiple reconstructive methods, has become one of preferred imaging methods in post-operative evaluation of EVE. Key words: Aortic disease; Stent; Tomography, X-ray computed; Angiography