Prior studies dating back to the 2000s have shown CTA to be a valuable tool to evaluate anatomic suitability for endovascular repair of the thoracic or abdominal aorta [31,60-63]. With anatomic coverage from the aortic root to the superficial femoral arteries, CTA can rapidly evaluate the extent of thoracoabdominal aneurysm or dissection as well as provide information valuable for preoperative planning such as aortic tortuosity, branch vessel location and patency, and suitability of femoral access vessels for endovascular repair. CTA can also readily evaluate for complications related to aortic pathology that could affect surgical or procedural plan including aortic rupture, dissection extension, or malperfusion syndrome. Although TAAA is traditionally treated with open repair, hybrid and endovascular repair of TAAA or dissections have increasingly been used over the past decade [14,64]. Techniques including snorkels/periscopes to allow perfusion of aortic branches, fenestrated EVAR, and branched EVAR have been used for thoracoabdominal aneurysms, and fenestration, branch vessel stenting, and true lumen stenting have progressively been used for thoracoabdominal dissection [9,14,64,65]. Many of these are complex procedures, and precise measurements of the aortic aneurysm or dissection before the procedure facilitates planning and ensures appropriate device availability at the time of procedure [9,65]. The thin slices, high spatial resolution, and isotropic data acquired with CTA permits advanced reconstruction techniques such as centerline measurements and double orthogonal measurements, permitting precise assessment of the aortic and branch vessel anatomy and detailed procedure planning [60- 62,66,67]. Inclusion of the pelvis in the study also aids in procedure planning by allowing evaluation of the iliofemoral access vessels.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. Prior studies dating back to the 2000s have shown CTA to be a valuable tool to evaluate anatomic suitability for endovascular repair of the thoracic or abdominal aorta [31,60-63]. With anatomic coverage from the aortic root to the superficial femoral arteries, CTA can rapidly evaluate the extent of thoracoabdominal aneurysm or dissection as well as provide information valuable for preoperative planning such as aortic tortuosity, branch vessel location and patency, and suitability of femoral access vessels for endovascular repair. CTA can also readily evaluate for complications related to aortic pathology that could affect surgical or procedural plan including aortic rupture, dissection extension, or malperfusion syndrome. Although TAAA is traditionally treated with open repair, hybrid and endovascular repair of TAAA or dissections have increasingly been used over the past decade [14,64]. Techniques including snorkels/periscopes to allow perfusion of aortic branches, fenestrated EVAR, and branched EVAR have been used for thoracoabdominal aneurysms, and fenestration, branch vessel stenting, and true lumen stenting have progressively been used for thoracoabdominal dissection [9,14,64,65]. Many of these are complex procedures, and precise measurements of the aortic aneurysm or dissection before the procedure facilitates planning and ensures appropriate device availability at the time of procedure [9,65]. The thin slices, high spatial resolution, and isotropic data acquired with CTA permits advanced reconstruction techniques such as centerline measurements and double orthogonal measurements, permitting precise assessment of the aortic and branch vessel anatomy and detailed procedure planning [60- 62,66,67]. Inclusion of the pelvis in the study also aids in procedure planning by allowing evaluation of the iliofemoral access vessels.