Abstract
Background: Endovascular aneurysm repair (EVAR) has become the primary choice of treatment for abdominal aortic aneurysm (AAA) and preventive intraoperative AAA sac embolization (SE) is an effective way to reduce endoleaks after EVAR. Preoperative planning of AAA SE has not been standardized yet, and typically requires a quite long and operator-dependent procedure using standard EVAR planning software. Methods: We introduce ‘EVAR-eaSE’, a software tool that we have developed to help vascular surgeons to plan the optimal SE procedure during EVAR, providing semi-automatic AAA segmentation and 3D modeling starting from patient scans, and then computing the aneurysm volumes. A preliminary accuracy evaluation on radiological phantoms, and a comparison with the commercial 3Mensio software for EVAR planning are carried out. Results: EVAR-eaSE software showed a good level of accuracy in aneurysm volume reconstruction and calculation (mean difference of 2.5% between real and segmented phantom volumes). A strong positive correlation (r = 0.940, r = 0.954, p < 0.001) was found between EVAR-eaSE computation of AAA Lumen and AAA Total volumes and the same measurements obtained with 3Mensio, for a database of 26 AAA cases. Conclusions: EVAR-eaSE demonstrated to be an easy-to-use, objective and accurate tool to assist the vascular surgeons in preoperative planning of SE during EVAR.
Highlights
In the last decade, endovascular aneurysm repair (EVAR) has become the primary choice of treatment for abdominal aortic aneurysm (AAA) in suitable patients due to its lower perioperative morbidity and mortality [1,2].Endoleaks, i.e., blood flow outside the lumen of the endograft but within the aneurysm sac, are the most frequent causes of reinterventions
For the analyzed 26 AAA cases, Mean values of AAA-Lumen Volume (LV) and AAA-Total Volume (TV) obtained from Endovascular aneurysm repair (EVAR)-eaSE
We have presented EVAR-eaSE software, a user-friendly tool that we have developed to ease the preoperative planning of EVAR procedure, the AAA sac embolization (SE)
Summary
Endovascular aneurysm repair (EVAR) has become the primary choice of treatment for abdominal aortic aneurysm (AAA) in suitable patients due to its lower perioperative morbidity and mortality [1,2].Endoleaks, i.e., blood flow outside the lumen of the endograft but within the aneurysm sac, are the most frequent causes of reinterventions. Endovascular aneurysm repair (EVAR) has become the primary choice of treatment for abdominal aortic aneurysm (AAA) in suitable patients due to its lower perioperative morbidity and mortality [1,2]. Type II endoleaks (ELII), caused by a backflow of collateral arteries into the aneurysm sac, if persistent (ELIIp, ≥6 months), can be associated with an increased incidence of the adverse outcomes, including the sac growth, the reintervention rate, Appl. Endovascular aneurysm repair (EVAR) has become the primary choice of treatment for abdominal aortic aneurysm (AAA) and preventive intraoperative AAA sac embolization (SE) is an effective way to reduce endoleaks after EVAR. Methods: We introduce ‘EVAR-eaSE’, a software tool that we have developed to help vascular surgeons to plan the optimal SE procedure during EVAR, providing semi-automatic AAA segmentation and 3D modeling starting from patient scans, and computing the aneurysm volumes. Conclusions: EVAR-eaSE demonstrated to be an easy-to-use, objective and accurate tool to assist the vascular surgeons in preoperative planning of SE during EVAR
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