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European Radiology

, Volume 22, Issue 2, pp 387–397 | Cite as

Radiology of advanced EVAR techniques in complex abdominal aortic aneurysms

  • Uei PuaEmail author
  • Kongteng Tan
Vascular-Interventional

Abstract

Advanced Endovascular Aortic Repair (EVAR) refers to devices and techniques used for endografting of aortic aneurysms that are considered anatomically unsuitable for conventional EVAR. Customised devices and modified use of conventional EVAR devices now overcome challenging landing zones. Fenestrated and branch devices, together with chimney and periscope techniques can be used to overcome proximal landing zone challenges, while iliac branch grafts and sandwich techniques have been used to address challenging distal iliac landing issues. Due to the novelty of these techniques, life-long surveillance is crucial, with CT Aortography (CTA) being the key investigation. Currently, the body of literature surrounding the imaging aspects of these techniques is scarce. The purpose of this imaging review is to illustrate the appearance of advanced EVAR in both routine surveillance and complicated cases, using conventional and novel CTA techniques.

Key Points

This review updates readers about advanced endovascular repair of abdominal aortic aneurysms

It illustrates the common CT appearances following advanced EVAR

Novel CTA techniques in troubleshooting problems unique to advanced EVAR are described

Keywords

Aortic aneurysm Endograft Fenestrated Branch Chimney 

Supplementary material

Movie 1

Multiplanar movie loop of Fig. 10, showing left renal fenestration endoleak. (WMV 294 kb)

Movie 2

Volumetric movie loop of Fig. 11, showing right renal fenestration endoleak. (WMV 224 kb)

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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  1. 1.Division of Vascular and Interventional Radiology, Department of Medical Imaging, Toronto General HospitalUniversity Health NetworkTorontoCanada
  2. 2.Department of Diagnostic RadiologyTan Tock Seng HospitalSingaporeSingapore

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