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Cardiovasc Intervent Radiol. 2009 May;32(3):535-8. doi: 10.1007/s00270-008-9399-0. Epub 2008 Jul 26.

Intraoperative DynaCT detection and immediate correction of a type Ia endoleak following endovascular repair of abdominal aortic aneurysm.

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St George's Regional Vascular Institute, St James Wing, St. Georges Hospital NHS Trust, Blackshaw Road, London, SW17 0QT, UK.


Reintervention following endovascular aneurysm repair (EVAR) is required in up to 10% of patients at 30 days and is associated with a demonstrable risk of increased mortality. Completion angiography cannot detect all graft-related anomalies and computed tomographic angiography is therefore mandatory to ensure clinical success. Intraoperative angiographic computed tomography (DynaCT; Siemens, Germany) utilizes cone beam reconstruction software and flat-panel detectors to generate CT-like images from rotational angiographic acquisitions. We report the intraoperative use of this novel technology in detecting and immediately treating a proximal anterior type Ia endoleak, following an endovascular abdominal aortic repair, which was not seen on completion angiography. Immediate evaluation of cross-sectional imaging following endograft deployment may allow for on-table correction of clinically significant stent-related complications. This should both improve technical success and minimize the need for early secondary intervention following EVAR.

[Indexed for MEDLINE]

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