Time-resolved, Cardiac-gated Computed Tomography After Endovascular Ascending Aortic and Arch Repair

Marton Berczeli, Ponraj Chinnadurai, Juan Carlos Ramirez-Giraldo, Zsolt Garami, Alan B. Lumsden, Marvin D. Atkins, Su Min Chang

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Better time-resolved imaging of stent grafts in the ascending aorta and arch accounting for cardiac motion is necessary to understand device-related complications and endoleaks. This report describes dynamic time-resolved computed tomographic angiography (d-CTA) and its combination with electrocardiography gating (d-gated CTA) to image stent grafts in the ascending aorta and to characterize endoleaks more clearly. Description: d-CTA involves multiple scans acquired at different time points along the contrast enhancement curve. d-Gated CTA involves concomitant electrocardiography gating in a predefined cardiac phase minimizing motion-induced artifacts. Evaluation: This report illustrates the utility of d-CTA and d-gated CTA in 2 clinical cases. d-CTA demonstrated a type 1A endoleak in a patient with an aortic arch aneurysm treated with total arch debranching and a thoracic stent graft. d-gated CTA demonstrated a type 1A endoleak in a patient with an ascending aortic pseudoaneurysm treated with aortic cuff placement. Conclusions: Dynamic, cardiac-gated CTA enables time-resolved angiographic imaging of the ascending aorta and arch without any cardiac motion–related artifacts. Such advanced imaging techniques help with better characterization of endoleaks after stent graft deployment in the ascending aorta and arch.

Original languageEnglish (US)
Pages (from-to)1685-1691
Number of pages7
JournalAnnals of Thoracic Surgery
Volume113
Issue number5
DOIs
StatePublished - May 2022

Keywords

  • Aorta/surgery
  • Aortic Aneurysm, Thoracic/complications
  • Blood Vessel Prosthesis/adverse effects
  • Blood Vessel Prosthesis Implantation/methods
  • Computed Tomography Angiography
  • Endoleak/diagnostic imaging
  • Endovascular Procedures/methods
  • Humans
  • Retrospective Studies
  • Stents/adverse effects

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

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