A 2011 study compared image quality, vessel measurements, and proposed endograft selection among MRA and CTA in 30 patients scheduled for EVAR [67]. This analysis found small differences in measured aortic diameter at multiple locations, all <1 mm between MRA and CTA [67]. Ultimately, this study concluded that the image quality for both CTA and MRA was, in general, adequate and that differences were not clinically relevant because all 30 patients had the same endograft components selected based on measurements [67]. Although the study was focused on AAA, the result is likely applicable to measurements of thoracoabdominal aneurysm or dissection, with the caveat that the complexity of endovascular thoracoabdominal repair may place a higher value on precise measurements. MRA is thus able to evaluate the extent of thoracoabdominal aneurysm or dissection as well as to provide information valuable for preoperative planning such as aortic tortuosity, branch vessel location and patency, and suitability of femoral access vessels for endovascular repair. MRA can also evaluate for complications related to aortic pathology that could affect surgical or procedural plan including aortic rupture, dissection extension, or malperfusion syndrome. Thoracoabdominal Aortic Aneurysm or Dissection 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].
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. A 2011 study compared image quality, vessel measurements, and proposed endograft selection among MRA and CTA in 30 patients scheduled for EVAR [67]. This analysis found small differences in measured aortic diameter at multiple locations, all <1 mm between MRA and CTA [67]. Ultimately, this study concluded that the image quality for both CTA and MRA was, in general, adequate and that differences were not clinically relevant because all 30 patients had the same endograft components selected based on measurements [67]. Although the study was focused on AAA, the result is likely applicable to measurements of thoracoabdominal aneurysm or dissection, with the caveat that the complexity of endovascular thoracoabdominal repair may place a higher value on precise measurements. MRA is thus able to evaluate the extent of thoracoabdominal aneurysm or dissection as well as to provide information valuable for preoperative planning such as aortic tortuosity, branch vessel location and patency, and suitability of femoral access vessels for endovascular repair. MRA can also evaluate for complications related to aortic pathology that could affect surgical or procedural plan including aortic rupture, dissection extension, or malperfusion syndrome. Thoracoabdominal Aortic Aneurysm or Dissection 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].