Thoracic Aortic Stent-Grafts: Utility of Multidetector CT for Pre-and Postprocedure Evaluation

Marchelle J. Bean, MD , Pamela T. Johnson, MD , Glen S. Roseborough, MD , James H. Black, MD , Elliot K. Fishman, MD

Indications for and experience with placement of endovascular stent-grafts in the thoracic aorta are still evolving. Common pathologic conditions of the thoracic aorta that are amenable to stent placement include penetrating ulcers, aortic dissection, aortic aneurysms, aor­tic rupture, and congenital abnormalities. Advances in multidetector computed tomography (CT) permit high-quality two-dimensional multiplanar reformation and three-dimensional rendering, which are essential for comprehensive assessment of the thoracic aorta. The ability of multidetector CT to allow detailed evaluation in any plane or perspective enables detection of thoracic aortic disease and assess­ment of its relationship to normal vessels. Potential complications of endovascular stent placement include endoleaks, stent migration, pseudoaneurysms, dissection, aortic perforation, kinking, thrombosis, and coverage of vital branch vessels. It is important for the radiologist to not only detect pathologic conditions of the thoracic aorta but also to provide the referring clinician with the necessary pre- and postpro­cedure information to determine appropriate clinical care.