Flat-panel CT as a new perinterventional imaging modality in aortic stentgraft procedures - Work in progress

Purpose: To evaluate the value of flat-panel CT (FP-CT) as a new perinterventional imaging modality in aortic stentgraft procedures. Materials and Methods: FP-CT was performed in 21 patients (19 males, mean age 77, range 54 to 90) from June 2005 to February 2007 immediately after endovascular treatment of thoracic and abdominal aortic aneurysms on the angiographic table. Nine thoracic aortic aneurysms were treated with Zenith (TM)-endoprosthesis. Nine of twelve abdominal aortic aneurysms were treated with Zenith (TM)-Endoprosthesis and three with an Excluder (TM)-Endoprosthesis. Images were acquired with a rotating C-arm and the following parameters: during an acquisition time of 20 seconds and at a rotation of 217 degrees, 538 projections were acquired. Contrast agent was administered in 14 patients. Images were displayed in MIP, MPR and VRT mode. Results: In all patients the stentgraft was shown exactly and the alignment of the prosthesis along the landing zones was well displayed. The aneurismal sack was well shown in all patients. 1 x an endoleak II was detected, 1 x an angiographically verified endoleak I was not detected. In one patient distal extension was considered due to suspected short stentgraft at the distal neck. Flat-panel CT showed sufficient neck coverage and no extension was inserted. Due to artifacts of the prosthesis, the platinum markers and the guide wire as well as due to pulsation of the aorta the, resolution of detail decreased and reduced the visualization of the alignment. Conclusion: FP-CT is a promising tool and may provide additional information, but further studies are necessary to define the value of flat-pa, nel CT in thoracic and abdominal aortic stentgraft procedures.