Intra-arterial catheter-directed CT angiography for assessment of endovascular aortic aneurysm repair

Autoři: Marco V. Usai aff001;  Mirjam Gerwing aff002;  Antje Gottschalk aff003;  Peter Sporns aff002;  Walter Heindel aff002;  Alexander Oberhuber aff001;  Moritz Wildgruber aff002;  Michael Köhler aff002
Působiště autorů: Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany aff001;  Department of Clinical Radiology, University Hospital Münster, Münster, Germany aff002;  Department of Anesthesiology, Intensive Care and Pain Medicine, Münster, University Hospital Münster, Germany aff003
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0221375



To compare the efficacy and safety as well as associated image quality of catheter-directed CT angiography (CCTA) with a low dose of iodine contrast agent compared to intravenous CTA in patients undergoing endovascular aortic aneurysm repair (EVAR).


Retrospective data analysis of 92 patients undergoing EVAR between January 2009 and December 2017 was performed. Patients were divided in two groups; those receiving CTA (n = 59) after intravenous contrast agent application and those receiving CCTA (n = 33) via an intraarterial catheter placed in the descending aorta. Demographic and cardiovascular risk factors as well as renal function parameters before, immediately after and 6–60 months after EVAR were evaluated. As primary endpoint, changes in serum creatinine levels in the two groups were evaluated. Secondary endpoints encompassed complications associated with intraarterial catheter placement. Objective (signal-to-noise ratios) and subjective image quality (5-point Likert scale) were compared.


Amount of contrast medium was significantly lower in CCTA compared to i.v. CTA (23 ± 7 ml vs. 119 ± 15 ml, p<0.0001). Patients undergoing catheter-directed CTA had higher baseline creatinine values compared to the group with intravenous iodine application (1.9 ± 0.6 mg/dl vs. 1.3 ± 0.5 mg/dl; p<0.0001). Follow-up serum creatinine levels however did not show significant alterations between the two groups (1.9 ± 0.4 mg/dl vs. 1.3 ± 0.5 mg/dl). No major complications were detected in the CCTA group. Signal-to-noise ratio (SNR) was comparable between i.v. CTA and CCTA (8.5 ± 4.6 vs. 7.7 ± 4.0; p = 0.37) and subjective image similarly revealed no differences with a good interobserver agreement (ICC = 0.647).


Catheter-directed CTA is safe and provides comparable image quality with a substantial retrenchment of the needed amount of iodine-based contrast medium. However, no benefit of the reduced contrast medium protocol with respect to renal function was observed.

Klíčová slova:

Biology and life sciences – Bioengineering – Biotechnology – Medical devices and equipment – Catheters – Anatomy – Renal system – Kidneys – Biochemistry – Biomarkers – Creatinine – Neuroscience – Neuroimaging – Engineering and technology – Medicine and health sciences – Cardiovascular anatomy – Blood vessels – Aorta – Vascular medicine – Vascular diseases – Aneurysms – Diagnostic medicine – Diagnostic radiology – Tomography – Computed axial tomography – Radiology and imaging – Nephrology – Chronic kidney disease – Research and analysis methods – Imaging techniques


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