Guidelines for clinical practice
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World J Radiol. Dec 31, 2009; 1(1): 63-71
Published online Dec 31, 2009. doi: 10.4329/wjr.v1.i1.63
Endovascular stent graft repair of abdominal aortic aneurysms: Current status and future directions
Zhonghua Sun
Zhonghua Sun, Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845, Australia
Author contributions: Sun Z solely contributed to this paper.
Correspondence to: Dr. Zhonghua Sun, Discipline of Medical Imaging, Department of Imaging and Applied Physics, Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845, Australia. z.sun@curtin.edu.au
Telephone: +61-8-92667509 Fax: +61-8-92662377
Received: December 3, 2009
Revised: December 22, 2009
Accepted: December 25, 2009
Published online: December 31, 2009
Abstract

Endovascular stent graft repair of abdominal aortic aneurysm (AAA) has undergone rapid developments since it was introduced in the early 1990s. Two main types of aortic stent grafts have been developed and are currently being used in clinical practice to deal with patients with complicated or unsuitable aneurysm necks, namely, suprarenal and fenestrated stent grafts. Helical computed tomography angiography has been widely recognized as the method of choice for both pre-operative planning and post-operative follow-up of endovascular repair (EVAR). In addition to 2D axial images, a number of 2D and 3D reconstructions are generated to provide additional information about imaging of the stent grafts in relation to the aortic aneurysm diameter and extent, encroachment of stent wires to the renal artery ostium and position of the fenestrated vessel stents. The purpose of this article is to provide an overview of applications of EVAR of AAA and diagnostic applications of 2D and 3D image visualizations in the assessment of treatment outcomes of EVAR. Interference of stent wires with renal blood flow from the hemodynamic point of view will also be discussed, and future directions explored.

Keywords: Abdominal aortic aneurysm; Stent graft; Computed tomography; Image visualization; Three-dimensional reconstruction; Follow-up