Infrarenal abdominal aortic aneurysms: implications of CT evaluation of size and configuration for placement of endovascular aortic grafts.

Abstract

To measure infrarenal abdominal aortic aneurysms and assess the implications and potential obstacles for placement of an endovascular aortic graft undergoing clinical testing in Europe. Helical computed tomography was used to measure 77 infrarenal aortic aneurysms (77 patients) and the distances between the aneurysms and the renal arteries and the aortic bifurcation. Mean length of the aneurysms was 8.2 cm; mean distance to the renal arteries, 2.7 cm; mean aortic diameter 1.5 cm distal to the renal arteries, 1.9 cm; and mean minimal diameter of perfused lumen, 2.5 cm. Thirteen aneurysms extended into the common iliac artery; 40 reached the bifurcation. The mean minimal luminal diameter of the iliac artery was 1.1 cm. Sufficient nonaneurysmal segments below the renal arteries and distal to the aneurysms are necessary for stent fixation. The large diameter of the delivery introducer in relation to the iliac arteries may be a major obstacle to graft delivery. At best, 33 patients could have benefited from use of the graft evaluated.