Although typically not performed for the purpose of procedural planning, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes in thoracoabdominal dissection or aneurysm. However, exclusion of the pelvis from the field of view carries the drawback of precluding evaluation of the iliofemoral access vessels if endovascular repair is considered. Furthermore, if the thoracoabdominal dissection or aneurysm extends into the pelvis, lack of pelvis evaluation could result in incomplete evaluation of the aortic pathology. In select cases with recent imaging of the pelvis or in cases of planned open repair without extension into the pelvic vasculature, further imaging of the pelvis vasculature may not be needed. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients but may be needed for preprocedure sizing and evaluation of pathology. CT Chest and Abdomen Without IV Contrast There is no relevant literature CT chest and abdomen without contrast for the planning of thoracoabdominal aortic endovascular or open repair. Compared with CT of the chest, abdomen, and pelvis, exclusion of the pelvis from the field of view carries the drawback of precluding evaluation of the iliofemoral access vessels if endovascular repair is considered. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients but may be needed for preprocedure sizing and evaluation of pathology. Thoracoabdominal Aortic Aneurysm or Dissection CTA Chest, Abdomen, and Pelvis With IV Contrast The high spatial resolution and profound, homogenous enhancement of the aorta and branch vessels in CTA allows for excellent preoperative assessment.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. Although typically not performed for the purpose of procedural planning, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes in thoracoabdominal dissection or aneurysm. However, exclusion of the pelvis from the field of view carries the drawback of precluding evaluation of the iliofemoral access vessels if endovascular repair is considered. Furthermore, if the thoracoabdominal dissection or aneurysm extends into the pelvis, lack of pelvis evaluation could result in incomplete evaluation of the aortic pathology. In select cases with recent imaging of the pelvis or in cases of planned open repair without extension into the pelvic vasculature, further imaging of the pelvis vasculature may not be needed. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients but may be needed for preprocedure sizing and evaluation of pathology. CT Chest and Abdomen Without IV Contrast There is no relevant literature CT chest and abdomen without contrast for the planning of thoracoabdominal aortic endovascular or open repair. Compared with CT of the chest, abdomen, and pelvis, exclusion of the pelvis from the field of view carries the drawback of precluding evaluation of the iliofemoral access vessels if endovascular repair is considered. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients but may be needed for preprocedure sizing and evaluation of pathology. Thoracoabdominal Aortic Aneurysm or Dissection CTA Chest, Abdomen, and Pelvis With IV Contrast The high spatial resolution and profound, homogenous enhancement of the aorta and branch vessels in CTA allows for excellent preoperative assessment.