Imaging of the thoracic aorta before and after stent-graft repair of aneurysms and dissections

Abstract

Thoracic endovascular aortic repair (TEVAR) has become widely accepted as an important option for treatment of thoracic aortic diseases. Cross-sectional radiologic imaging plays a crucial role for evaluating a patient's candidacy for planning of the intervention and for assessment of postprocedural results and complications of TEVAR. Recent advances in imaging technologies, in part inspired by advances in stent-graft technology, have drastically changed the character and role of pre- and postprocedural imaging. Three-dimensional (3D) datasets acquired quickly by multidetector computed tomography (MDCT), angiography, or magnetic resonance angiography (MRA) allow multiplanar reformations and 3D viewing, as well as quantitative assessment of vessel lumens, walls, and surroundings. Catheter angiography, in contrast, is performed intraoperatively almost exclusively, and is no longer the gold standard for diagnostic or planning purposes. This article reviews state-of-the-art pre- and postprocedural imaging for TEVAR, especially focusing on the role of MDCT angiography.