Justus E. Roos, MD, Jeffrey C

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Presentation transcript:

Detection of endograft fractures with multidetector row computed tomography Justus E. Roos, MD, Jeffrey C. Hellinger, MD, Richard Hallet, MD, Dominik Fleischmann, MD, Christopher K. Zarins, MD, Geoffrey D. Rubin, MD Journal of Vascular Surgery Volume 42, Issue 5, Pages 1002-1006 (November 2005) DOI: 10.1016/j.jvs.2005.07.009 Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 1 Multidetector row computed tomography images of a patient treated with the AneuRx endograft. The first postdeployment MIP image (A) demonstrates anterior angulation of the proximal endograft; the MIP image 25 months after deployment (B) reveals a marked change in the angulation of the endograft, with caudal migration of the anterior rim of the endograft and no change in the position of the posterior rim of the endograft. This was associated with the development of a type I endoleak. A cross-sectional image (C) demonstrates the proximal type I endoleak with contrast in the aneurysm sac (arrowheads) and a break in the integrity of the stent ring (arrow). Volume-rendered right oblique (D) and left oblique (E) images demonstrate a nitinol stent ring fracture with disruption of the metallic framework (double arrowheads). Journal of Vascular Surgery 2005 42, 1002-1006DOI: (10.1016/j.jvs.2005.07.009) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions

Fig 2 Transverse multidetector row computed tomography and volume-rendered (VR) images demonstrating the Talent endograft at 15 months after deployment. The transverse image (A) and VR image (B) demonstrate a proximal type I endoleak with contrast outside the lumen of the endograft in the posterior aspect of the aneurysm sac (arrowheads). Although an isolated metallic strut fracture is hard to recognize on the transverse image, a VR image (C) through the same view angle as (B), but rendered with an opacity transfer function that excludes the contrast-enhanced aortic lumen, allows precise localization of the metallic framework. Fracture of the uppermost stent ring is apparent (arrows). A VR image (D) isolates the proximal stent ring and best demonstrates the separation (curved arrow) of the metallic framework at the stent ring fracture. Journal of Vascular Surgery 2005 42, 1002-1006DOI: (10.1016/j.jvs.2005.07.009) Copyright © 2005 The Society for Vascular Surgery Terms and Conditions