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Thoracic Aortic Stent-Grafts: Utility of Multidetector CT for Pre- and Postprocedure Evaluation¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Science (M.J.B., P.T.J., E.K.F.) and Department of Surgery (G.S.R., J.H.B.), Johns Hopkins Medical Institutions, 601 N Caroline St, Room 3140A, Baltimore, MD 21287. Presented as an education exhibit at the 2007 RSNA Annual Meeting. Received March 17, 2008; revision requested April 23 and received June 3; accepted June 24. G.S.R. consults for Medtronic; E.K.F. receives research support from Siemens and General Electric, is on the advisory boards of Siemens and General Electric, and is a cofounder of HipGraphics; all other authors have no financial relationships to disclose. Address correspondence to M.J.B. (e-mail: Mbean3{at}jhmi.edu).

Indications for and experience with placement of endovascular stent-grafts in the thoracic aorta are still evolving. Common pathologic conditions of the thoracic aorta that are amenable to stent placement include penetrating ulcers, aortic dissection, aortic aneurysms, aortic rupture, and congenital abnormalities. Advances in multidetector computed tomography (CT) permit high-quality two-dimensional multiplanar reformation and three-dimensional rendering, which are essential for comprehensive assessment of the thoracic aorta. The ability of multidetector CT to allow detailed evaluation in any plane or perspective enables detection of thoracic aortic disease and assessment of its relationship to normal vessels. Potential complications of endovascular stent placement include endoleaks, stent migration, pseudoaneurysms, dissection, aortic perforation, kinking, thrombosis, and coverage of vital branch vessels. It is important for the radiologist to not only detect pathologic conditions of the thoracic aorta but also to provide the referring clinician with the necessary pre- and postprocedure information to determine appropriate clinical care.

© RSNA, 2008