Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms
Purpose: To determine if oblique angulation of the image intensifier is adequate to image the entire length of the common iliac artery during endovascular aneurysm repair or if additional caudal tilt is necessary. Methods: Using a 3D workstation, the apparent level of the iliac bifurcation (distal l...
Gespeichert in:
Veröffentlicht in: | Journal of endovascular therapy 2009-06, Vol.16 (3), p.373-379 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 379 |
---|---|
container_issue | 3 |
container_start_page | 373 |
container_title | Journal of endovascular therapy |
container_volume | 16 |
creator | BEng, Olufemi A. Oshin Bown, Matthew J. McWilliams, Richard G. Brennan, John A. Vallabhaneni, S. Rao |
description | Purpose:
To determine if oblique angulation of the image intensifier is adequate to image the entire length of the common iliac artery during endovascular aneurysm repair or if additional caudal tilt is necessary.
Methods:
Using a 3D workstation, the apparent level of the iliac bifurcation (distal limit of the stent-graft) was determined on computed tomographic angiography by profiling the common iliac segment in oblique angulation only and repeated with a combination of oblique angulation and caudal tilt. Two independent observers measured twice the apparent length of the iliac segment in both profiles for 50 patients according to a set protocol. Intra- and interobserver variability was calculated using the Bland and Altman method; the differences between the two different profiles were tested using paired t tests.
Results:
Of the 50 CTA datasets reviewed, 2 datasets were excluded owing to extensive calcification of the iliac system that prevented accurate interpretation of the image. Of the 96 segments studied, the iliac segments appeared longer (better profiled) with a combination of caudal tilt and oblique angulation in 80%, with an average discrepancy of 9 mm for observer 1 (range −1 to +28) and 7 mm for observer 2 (0 to +26). The effect of caudal tilt was statistically significant for individual observers (p=0.001 and 0.024, respectively). Forty-six percent of iliac segments measured by observer 1 and 35% by observer 2 showed that the addition of caudal tilt resulted in improved profiling by at least 10 mm. Although inter- and intraobserver variation was significant, the gain in apparent iliac length with the addition of caudal tilt was preserved.
Conclusion:
When profiled with oblique angulation alone, the location of the iliac bifurcation may appear higher than its true location, resulting in underutilization of the iliac segment by >10 mm in over a third of the patients. The problem is corrected by employing additional caudal tilt. |
doi_str_mv | 10.1583/09-2736.1 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67541987</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_09-2736.1</sage_id><sourcerecordid>67541987</sourcerecordid><originalsourceid>FETCH-LOGICAL-c301t-87b1a96422a1bf2b414ffefe2addd8d1d5645fe23845bc9c6041ade2a3ca77583</originalsourceid><addsrcrecordid>eNplkFtLwzAYhoMoTqcX_gEJXghedOZLkx4ux5g6GAx0Xoc0SWdH28ykFfbvTdlgoFc5PbzfmwehOyAT4Fn8TPKIpnEygTN0BZzxCDgn58OeJlFCaDZC195vCaFAAS7RCPKE0TRPr5BZ7bqqkTVeG_XVVt-9waV1eNHITdVu8KKupMIfZtOYtvNY9264nbfa_kiv-lo6_G52snLYlnhaaNtUbQibWtdVCk9b07u9b_wNuihl7c3tcR2jz5f5evYWLVevi9l0GamYQBdlaQFyqEYlFCUtGLCyNKWhUmudadA8YTwc44zxQuUqIQykDs-xkmkaTIzR4yF352z4iu9EU3ll6lq2xvZeJClnkGdpAB_-gFvbu1Ddi2AIYkYoD9DTAVLOeu9MKXYuuHJ7AUQM4gXJxSBeQGDvj4F90Rh9Io-mT9W83JjTtP9Jv6iYiZ0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211134025</pqid></control><display><type>article</type><title>Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>BEng, Olufemi A. Oshin ; Bown, Matthew J. ; McWilliams, Richard G. ; Brennan, John A. ; Vallabhaneni, S. Rao</creator><creatorcontrib>BEng, Olufemi A. Oshin ; Bown, Matthew J. ; McWilliams, Richard G. ; Brennan, John A. ; Vallabhaneni, S. Rao</creatorcontrib><description>Purpose:
To determine if oblique angulation of the image intensifier is adequate to image the entire length of the common iliac artery during endovascular aneurysm repair or if additional caudal tilt is necessary.
Methods:
Using a 3D workstation, the apparent level of the iliac bifurcation (distal limit of the stent-graft) was determined on computed tomographic angiography by profiling the common iliac segment in oblique angulation only and repeated with a combination of oblique angulation and caudal tilt. Two independent observers measured twice the apparent length of the iliac segment in both profiles for 50 patients according to a set protocol. Intra- and interobserver variability was calculated using the Bland and Altman method; the differences between the two different profiles were tested using paired t tests.
Results:
Of the 50 CTA datasets reviewed, 2 datasets were excluded owing to extensive calcification of the iliac system that prevented accurate interpretation of the image. Of the 96 segments studied, the iliac segments appeared longer (better profiled) with a combination of caudal tilt and oblique angulation in 80%, with an average discrepancy of 9 mm for observer 1 (range −1 to +28) and 7 mm for observer 2 (0 to +26). The effect of caudal tilt was statistically significant for individual observers (p=0.001 and 0.024, respectively). Forty-six percent of iliac segments measured by observer 1 and 35% by observer 2 showed that the addition of caudal tilt resulted in improved profiling by at least 10 mm. Although inter- and intraobserver variation was significant, the gain in apparent iliac length with the addition of caudal tilt was preserved.
Conclusion:
When profiled with oblique angulation alone, the location of the iliac bifurcation may appear higher than its true location, resulting in underutilization of the iliac segment by >10 mm in over a third of the patients. The problem is corrected by employing additional caudal tilt.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/09-2736.1</identifier><identifier>PMID: 19642797</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Angiography ; Angioplasty, Balloon ; Aortic Aneurysm, Abdominal - diagnostic imaging ; Aortic Aneurysm, Abdominal - surgery ; Blood Vessel Prosthesis Implantation ; Humans ; Iliac Artery - diagnostic imaging ; Imaging, Three-Dimensional ; Medical imaging ; Observer Variation ; Patients ; Retrospective Studies ; Stents ; Tomography, X-Ray Computed ; Veins & arteries</subject><ispartof>Journal of endovascular therapy, 2009-06, Vol.16 (3), p.373-379</ispartof><rights>2009 International Society of Endovascular Specialists</rights><rights>Copyright Allen Press Publishing Services Jun 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c301t-87b1a96422a1bf2b414ffefe2addd8d1d5645fe23845bc9c6041ade2a3ca77583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/09-2736.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/09-2736.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19642797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>BEng, Olufemi A. Oshin</creatorcontrib><creatorcontrib>Bown, Matthew J.</creatorcontrib><creatorcontrib>McWilliams, Richard G.</creatorcontrib><creatorcontrib>Brennan, John A.</creatorcontrib><creatorcontrib>Vallabhaneni, S. Rao</creatorcontrib><title>Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To determine if oblique angulation of the image intensifier is adequate to image the entire length of the common iliac artery during endovascular aneurysm repair or if additional caudal tilt is necessary.
Methods:
Using a 3D workstation, the apparent level of the iliac bifurcation (distal limit of the stent-graft) was determined on computed tomographic angiography by profiling the common iliac segment in oblique angulation only and repeated with a combination of oblique angulation and caudal tilt. Two independent observers measured twice the apparent length of the iliac segment in both profiles for 50 patients according to a set protocol. Intra- and interobserver variability was calculated using the Bland and Altman method; the differences between the two different profiles were tested using paired t tests.
Results:
Of the 50 CTA datasets reviewed, 2 datasets were excluded owing to extensive calcification of the iliac system that prevented accurate interpretation of the image. Of the 96 segments studied, the iliac segments appeared longer (better profiled) with a combination of caudal tilt and oblique angulation in 80%, with an average discrepancy of 9 mm for observer 1 (range −1 to +28) and 7 mm for observer 2 (0 to +26). The effect of caudal tilt was statistically significant for individual observers (p=0.001 and 0.024, respectively). Forty-six percent of iliac segments measured by observer 1 and 35% by observer 2 showed that the addition of caudal tilt resulted in improved profiling by at least 10 mm. Although inter- and intraobserver variation was significant, the gain in apparent iliac length with the addition of caudal tilt was preserved.
Conclusion:
When profiled with oblique angulation alone, the location of the iliac bifurcation may appear higher than its true location, resulting in underutilization of the iliac segment by >10 mm in over a third of the patients. The problem is corrected by employing additional caudal tilt.</description><subject>Angiography</subject><subject>Angioplasty, Balloon</subject><subject>Aortic Aneurysm, Abdominal - diagnostic imaging</subject><subject>Aortic Aneurysm, Abdominal - surgery</subject><subject>Blood Vessel Prosthesis Implantation</subject><subject>Humans</subject><subject>Iliac Artery - diagnostic imaging</subject><subject>Imaging, Three-Dimensional</subject><subject>Medical imaging</subject><subject>Observer Variation</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Tomography, X-Ray Computed</subject><subject>Veins & arteries</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNplkFtLwzAYhoMoTqcX_gEJXghedOZLkx4ux5g6GAx0Xoc0SWdH28ykFfbvTdlgoFc5PbzfmwehOyAT4Fn8TPKIpnEygTN0BZzxCDgn58OeJlFCaDZC195vCaFAAS7RCPKE0TRPr5BZ7bqqkTVeG_XVVt-9waV1eNHITdVu8KKupMIfZtOYtvNY9264nbfa_kiv-lo6_G52snLYlnhaaNtUbQibWtdVCk9b07u9b_wNuihl7c3tcR2jz5f5evYWLVevi9l0GamYQBdlaQFyqEYlFCUtGLCyNKWhUmudadA8YTwc44zxQuUqIQykDs-xkmkaTIzR4yF352z4iu9EU3ll6lq2xvZeJClnkGdpAB_-gFvbu1Ddi2AIYkYoD9DTAVLOeu9MKXYuuHJ7AUQM4gXJxSBeQGDvj4F90Rh9Io-mT9W83JjTtP9Jv6iYiZ0</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>BEng, Olufemi A. Oshin</creator><creator>Bown, Matthew J.</creator><creator>McWilliams, Richard G.</creator><creator>Brennan, John A.</creator><creator>Vallabhaneni, S. Rao</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>200906</creationdate><title>Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms</title><author>BEng, Olufemi A. Oshin ; Bown, Matthew J. ; McWilliams, Richard G. ; Brennan, John A. ; Vallabhaneni, S. Rao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c301t-87b1a96422a1bf2b414ffefe2addd8d1d5645fe23845bc9c6041ade2a3ca77583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Angiography</topic><topic>Angioplasty, Balloon</topic><topic>Aortic Aneurysm, Abdominal - diagnostic imaging</topic><topic>Aortic Aneurysm, Abdominal - surgery</topic><topic>Blood Vessel Prosthesis Implantation</topic><topic>Humans</topic><topic>Iliac Artery - diagnostic imaging</topic><topic>Imaging, Three-Dimensional</topic><topic>Medical imaging</topic><topic>Observer Variation</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Tomography, X-Ray Computed</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>BEng, Olufemi A. Oshin</creatorcontrib><creatorcontrib>Bown, Matthew J.</creatorcontrib><creatorcontrib>McWilliams, Richard G.</creatorcontrib><creatorcontrib>Brennan, John A.</creatorcontrib><creatorcontrib>Vallabhaneni, S. Rao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>BEng, Olufemi A. Oshin</au><au>Bown, Matthew J.</au><au>McWilliams, Richard G.</au><au>Brennan, John A.</au><au>Vallabhaneni, S. Rao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2009-06</date><risdate>2009</risdate><volume>16</volume><issue>3</issue><spage>373</spage><epage>379</epage><pages>373-379</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To determine if oblique angulation of the image intensifier is adequate to image the entire length of the common iliac artery during endovascular aneurysm repair or if additional caudal tilt is necessary.
Methods:
Using a 3D workstation, the apparent level of the iliac bifurcation (distal limit of the stent-graft) was determined on computed tomographic angiography by profiling the common iliac segment in oblique angulation only and repeated with a combination of oblique angulation and caudal tilt. Two independent observers measured twice the apparent length of the iliac segment in both profiles for 50 patients according to a set protocol. Intra- and interobserver variability was calculated using the Bland and Altman method; the differences between the two different profiles were tested using paired t tests.
Results:
Of the 50 CTA datasets reviewed, 2 datasets were excluded owing to extensive calcification of the iliac system that prevented accurate interpretation of the image. Of the 96 segments studied, the iliac segments appeared longer (better profiled) with a combination of caudal tilt and oblique angulation in 80%, with an average discrepancy of 9 mm for observer 1 (range −1 to +28) and 7 mm for observer 2 (0 to +26). The effect of caudal tilt was statistically significant for individual observers (p=0.001 and 0.024, respectively). Forty-six percent of iliac segments measured by observer 1 and 35% by observer 2 showed that the addition of caudal tilt resulted in improved profiling by at least 10 mm. Although inter- and intraobserver variation was significant, the gain in apparent iliac length with the addition of caudal tilt was preserved.
Conclusion:
When profiled with oblique angulation alone, the location of the iliac bifurcation may appear higher than its true location, resulting in underutilization of the iliac segment by >10 mm in over a third of the patients. The problem is corrected by employing additional caudal tilt.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>19642797</pmid><doi>10.1583/09-2736.1</doi><tpages>7</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1526-6028 |
ispartof | Journal of endovascular therapy, 2009-06, Vol.16 (3), p.373-379 |
issn | 1526-6028 1545-1550 |
language | eng |
recordid | cdi_proquest_miscellaneous_67541987 |
source | Access via SAGE; MEDLINE; Alma/SFX Local Collection |
subjects | Angiography Angioplasty, Balloon Aortic Aneurysm, Abdominal - diagnostic imaging Aortic Aneurysm, Abdominal - surgery Blood Vessel Prosthesis Implantation Humans Iliac Artery - diagnostic imaging Imaging, Three-Dimensional Medical imaging Observer Variation Patients Retrospective Studies Stents Tomography, X-Ray Computed Veins & arteries |
title | Optimal Technique for Imaging Iliac Segments during Endovascular Repair of Abdominal Aortic Aneurysms |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T10%3A57%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Optimal%20Technique%20for%20Imaging%20Iliac%20Segments%20during%20Endovascular%20Repair%20of%20Abdominal%20Aortic%20Aneurysms&rft.jtitle=Journal%20of%20endovascular%20therapy&rft.au=BEng,%20Olufemi%20A.%20Oshin&rft.date=2009-06&rft.volume=16&rft.issue=3&rft.spage=373&rft.epage=379&rft.pages=373-379&rft.issn=1526-6028&rft.eissn=1545-1550&rft_id=info:doi/10.1583/09-2736.1&rft_dat=%3Cproquest_cross%3E67541987%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=211134025&rft_id=info:pmid/19642797&rft_sage_id=10.1583_09-2736.1&rfr_iscdi=true |