Sources of error in the measurement of aortic diameter in computed tomography scans.


OBJECTIVE:This study was conducted to determine the differences in the diameter of the thoracic aorta when measured from electrocardiographic (ECG)-gated and nongated computed tomography (CT) angiography. Another aim was to define the difference in the aortic diameter when it is measured at peak systole and end diastole in ECG-gated scans. METHODS:The gated and nongated CT angiograms of 27 patients (mean age, 58 ± 16 standard deviation [SD] years) obtained on a 256-slice multidetector CT scanner were used. The transverse and anteroposterior diameters and the lumen areas were measured at 1, 4, and 8 cm below the origin of the left subclavian artery. RESULTS:There was a significant difference in the aortic measurements of diameter between gated and nongated scans found in samples taken at 1, 4, and 8 cm distal to the left subclavian artery (P < .0001). We found a considerable difference between the systolic and diastolic diameters (P < .0001). The maximum change in diameter between systole and diastole was 2.9 ± 0.9 (SD) mm (14.5%, P < .0001) at 1 cm, 5.4 mm (22.6%; median, 1.7 mm; P < .0001) at 4 cm, and 4.4 mm (16.9%; median, 1.3 mm; P < .0001) at 8 cm. There was a significant difference between the transverse and anteroposterior diameters in systole and diastole at all locations (P < .0001): The maximum change in diameter between transverse and anteroposterior diameters in systole was 5.4 ± 1.1 (SD) mm (15.7%, P < .0001) at 1 cm, 5.8 mm (19%; median, 1.4 mm; P < .0001) at 4 cm, and 5 mm (15%; median, 1.02 mm; P < .0001) at 8 cm. There was also a substantial difference between measuring the transverse diameter directly and deriving it from the lumen area (P < .0001). CONCLUSIONS:Our results showed an important difference between systolic and diastolic diameters measurements in ECG-gated scans. The standard protocol for measuring aortic diameters in gated scans of the thoracic aorta uses images at end diastole because the lack of wall motion at this time provides better resolution. This is likely to result in undersizing that, in some instances, may threaten stability and the proper seal of the stent graft. The dimensions of the aorta in a gated CT should be measured at peak systole rather than the conventional end diastole used today. Most medical centers use nongated CT or gated CT scans in end diastole to calculate sizes of endografts. In view of our findings, the latter method could result in potential complications.


J Vasc Surg


Parodi J,Berguer R,Carrascosa P,Khanafer K,Capunay C,Wizauer E




Has Abstract


2014-01-01 00:00:00














  • Totally laparoscopic aortic repair: a new device for direct transperitoneal approach.

    abstract::On the basis of our experience with more than 71 cases of totally laparoscopic aortic surgery by the retrocolic approach, we have developed a new technique by a simple transperitoneal approach. The purpose of this report is to describe that technique and the novel laparoscopic bowel retractor used to ensure stable exp...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Cau J,Ricco JB,Deelchand A,Berard X,Cau B,Costecalde M,Chaufour X,Barret F,Barret A,Bossavy JP

    更新日期:2005-05-01 00:00:00

  • Validating the use of contrast-induced nephropathy prediction models in endovascular aneurysm repairs.

    abstract:BACKGROUND:Existing risk prediction models for contrast-induced nephropathy (CIN) are based on studies for percutaneous coronary interventions, with none validated for use in vascular procedures. We aim to validate existing CIN prediction models in patients who underwent aortic endovascular aneurysm repair (EVAR). MET...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Cheng EL,Hong Q,Yong E,Chandrasekar S,Tan GWL,Lo ZJ

    更新日期:2020-05-01 00:00:00

  • The effects of extremely low shear stress on cellular proliferation and neointimal thickening in the failing bypass graft.

    abstract:OBJECTIVE:Previous studies demonstrating a correlation between low shear stress (tau = 5-15 dyne/cm(2)) and experimental vein graft neointimal thickening (NIT) support the role of low tau in vein graft failure. However, a simple linear relationship between low tau and NIT would underestimate the degree of NIT evident i...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Meyerson SL,Skelly CL,Curi MA,Shakur UM,Vosicky JE,Glagov S,Schwartz LB,Christen T,Gabbiani G

    更新日期:2001-07-01 00:00:00

  • Prophylactic muscle flaps in vascular surgery.

    abstract:BACKGROUND:Vascular surgery-related groin complications can lead to catastrophic outcomes and pose a significant healthcare burden. We have taken steps to reduce potential complications at the time of initial surgery by performing prophylactic muscle flaps. The purpose of this study is to evaluate the efficacy and bene...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Fischer JP,Nelson JA,Mirzabeigi MN,Wang GJ,Foley PJ 3rd,Wu LC,Woo EY,Kanchwala S

    更新日期:2012-04-01 00:00:00

  • Increasing surgeon volume correlates with patient survival following open abdominal aortic aneurysm repair.

    abstract:OBJECTIVE:The annual number of open abdominal aortic aneurysm (AAA) repairs has decreased dramatically over the last decade, making the search for physician case volume thresholds more important. The purpose of this study was to identify a minimum threshold for annual surgeon case volume in open AAA repair. METHODS:Th...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Esce A,Medhekar A,Fleming F,Glocker R,Ellis J,Raman K,Stoner M,Doyle A

    更新日期:2019-09-01 00:00:00

  • National audit of the recent utilization of endovascular abdominal aortic aneurysm repair in Canada: 2003 to 2004.

    abstract:OBJECTIVES:Worldwide, increasing proportions of aortic aneurysms are repaired electively via the endovascular route. The purpose of this study was to report the recent utilization of endovascular repair in Canada by reviewing a national administrative database. METHODS:The Canadian Institute for Health Information dat...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Forbes TL,Lawlor DK,Derose G,Harris KA

    更新日期:2005-09-01 00:00:00

  • The role of mandatory lifelong annual surveillance after thoracic endovascular repair.

    abstract::Thoracic endovascular aortic repair (TEVAR) has become an attractive and well-accepted option for the management of the various thoracic aortic pathologies that vascular surgeons are confronted with. As in the abdominal aorta, current management trends include the treatment of younger patients with longer life expecta...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Wong S,Mastracci TM,Katsargyris A,Verhoeven EL

    更新日期:2012-12-01 00:00:00

  • Selective renal blood perfusion induces renal tubules injury in a porcine model.

    abstract:OBJECTIVE:Extracorporeal circulation is routinely used in thoracoabdominal aortic aneurysm repair to preserve blood perfusion. Despite this protective measure, acute and chronic kidney disorders can develop. Therefore, the aim of this study was to establish a new large-animal model to assess the efficacy of selective r...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Kalder J,Kokozidou M,Keschenau P,Tamm M,Greiner A,Koeppel TA,Tolba R,Jacobs MJ

    更新日期:2016-03-01 00:00:00

  • Experimental repair of venous valvular insufficiency using a cryopreserved venous valve allograft aided by a distal arteriovenous fistula.

    abstract:PURPOSE:To evaluate the patency and hemodynamic impact of a cryopreserved allograft venous valve transplanted to the superficial femoral vein (SFV) of a canine insufficiency model aided by a distal arteriovenous fistula (dAVF). METHODS:Eight greyhounds had intravenous hemodynamic parameters measured (venous filling ti...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Burkhart HM,Fath SW,Dalsing MC,Sawchuk AP,Cikrit DF,Lalka SG

    更新日期:1997-11-01 00:00:00

  • Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization.

    abstract:OBJECTIVE:Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) that also involve the common iliac artery (CIA) typically is accomplished by endograft limb extension into the external iliac artery (EIA). In order to prevent endoleak, the internal iliac artery (IIA) is usually embolized, or alternativ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Papazoglou KO,Sfyroeras GS,Zambas N,Konstantinidis K,Kakkos SK,Mitka M

    更新日期:2012-08-01 00:00:00

  • Governmental regulations and radiation exposure.

    abstract:BACKGROUND:The use of radiation for medical purposes falls under the purview of the Food and Drug Administration (FDA) and individual states. Enhanced regulations are in place to promote the right exam for the right reason at the right time for every patient exposed to medical x-rays. METHODS:The February 2010 FDA ini...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Killewich LA,Singleton TA

    更新日期:2011-01-01 00:00:00

  • Carotid body tumor: atypical angiogram of a functional tumor.

    abstract::Carotid body tumors (CBTs) are rare, usually benign, neoplasms of the extra-adrenal paraganglion system. They are almost always nonfunctional. The diagnosis is generally confirmed by an angiogram that shows a vascular tumor enlarging the space between the internal and external carotid arteries. A 55-year-old man with ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章,评审


    authors: MacGillivray DC,Perry MO,Selfe RW,Nydick I

    更新日期:1987-03-01 00:00:00

  • Volumetric analysis of the initial index computed tomography scan can predict the natural history of acute uncomplicated type B dissections.

    abstract:OBJECTIVE:Our objective was to characterize the predictive impact of computed tomography (CT) scan volumetric analysis on the natural history of acute uncomplicated type B aortic dissections (ADs). METHODS:We conducted a retrospective review of patients with acute type B ADs from 2009 to 2014. On an iNtuition workstat...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Lavingia KS,Larion S,Ahanchi SS,Ammar CP,Bhasin M,Mirza AK,Dexter DJ,Panneton JM

    更新日期:2015-10-01 00:00:00

  • Can carotid endarterectomy improve metabolic status in patients with asymptomatic internal carotid artery flow lesion? Studies with localized in vivo proton magnetic resonance spectroscopy.

    abstract:PURPOSE:Carotid endarterectomy (CEA) has proven to be effective in the prevention of stroke in patients with significant internal carotid artery (ICA) stenosis. However, whether increased cerebral blood flow after CEA improves the cerebral metabolism in patients with asymptomatic ICA flow lesions is unknown. Localized ...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Kim GE,Lee JH,Cho YP

    更新日期:2002-09-01 00:00:00

  • Surgical resection of a large recurrent pelvic arteriovenous malformation using deep hypothermic circulatory arrest.

    abstract::Transcatheter embolization has emerged as the treatment of choice for pelvic arteriovenous malformations (AVMs), because surgical resection may be difficult and is associated with a high recurrence rate. We report a patient with a large recurrent pelvic AVM in whom transcatheter embolization was not feasible. This pat...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: McCready RA,Fehrenbacher JW,Divelbiss JL,Bryant A,Savader S

    更新日期:2004-06-01 00:00:00

  • Prediction of aneurysm formation in vascular grafts of biologic origin.

    abstract::Other than review of clinical experience, no assay exists that can reliably predict the long-term potential for aneurysm formation in an arterial prosthesis of biologic origin. Since mural degeneration probably results from proteolytic digestion, an in vitro assay was devised that used graft perfusion with 1% collagen...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Hamilton G,Megerman J,L'Italien GJ,Warnock DF,Schmitz-Rixen T,Brewster DC,Abbott WM

    更新日期:1988-03-01 00:00:00

  • A fifteen-year experience with carotid endarterectomy after a formal operative protocol requiring highly frequent patch angioplasty.

    abstract:PURPOSE:The early and late outcomes of carotid endarterectomy (CEA) following a rigid protocol of patch angioplasty or occasionally interposition bypass grafting, when the arteriotomy required to obtain a complete internal carotid end point extended distal to the bulb segment, and primary closure, when it was limited t...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Archie JP Jr

    更新日期:2000-04-01 00:00:00

  • Antisense basic fibroblast growth factor alters the time course of mitogen-activated protein kinase in arterialized vein graft remodeling.

    abstract:PURPOSE:Neointimal hyperplasia (NIH) is complete by 3 weeks in rabbit vein grafts implanted into the arterial circulation. Activation of the mitogen-activated protein kinase (MAPK) family of protein kinases is thought to be critical in remodeling events such as cellular proliferation, differentiation, and migration, as...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Yamashita A,Hanna AK,Hirata S,Dardik A,Sumpio BE

    更新日期:2003-04-01 00:00:00

  • Surgical management of pediatric renin-mediated hypertension secondary to renal artery occlusive disease and abdominal aortic coarctation.

    abstract:BACKGROUND:Renovascular hypertension (RVH) associated with renal artery and abdominal aortic narrowings is the third most common cause of pediatric hypertension. Untreated children may experience major cardiopulmonary complications, stroke, renal failure, and death. The impetus of this study was to describe the increas...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Coleman DM,Eliason JL,Beaulieu R,Jackson T,Karmakar M,Kershaw DB,Modi ZJ,Ganesh SK,Khaja MS,Williams D,Stanley JC,University of Michigan Pediatric Renovascular Hypertension Center.

    更新日期:2020-12-01 00:00:00

  • Venous reconstructions in lower limbs associated with resection of malignancies.

    abstract:BACKGROUND:Patients with tumors in the limbs who undergo surgical treatment may have involvement of major vessels. Major arteries are always reconstructed for limb salvage. Major veins may be reconstructed to avoid the onset of venous hypertension signs and symptoms. The objective of this study was to analyze the resul...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Nishinari K,Wolosker N,Yazbek G,Zerati AE,Nishimoto IN

    更新日期:2006-11-01 00:00:00

  • Transcranial Doppler findings during thoracic endovascular aortic repair.

    abstract:OBJECTIVE:Thoracic endograft placement has become an acceptable treatment alternative to open repair of the thoracic aorta. Cerebral embolization when manipulating the aortic arch during cardiac catheterization is well described, but the influence of thoracic endovascular aortic repair (TEVAR) on this event remains poo...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Bismuth J,Garami Z,Anaya-Ayala JE,Naoum JJ,El Sayed HF,Peden EK,Lumsden AB,Davies MG

    更新日期:2011-08-01 00:00:00

  • The contribution of the external carotid artery to cerebral perfusion in carotid disease.

    abstract:PURPOSE:In the presence of carotid occlusion, the external carotid artery (ECA) becomes an important source of cerebral blood flow, especially if the circle of Willis is incomplete. The contribution of the ECA to hemispheric blood flow in patients with severe ipsilateral carotid stenosis has never been previously inves...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Fearn SJ,Picton AJ,Mortimer AJ,Parry AD,McCollum CN

    更新日期:2000-05-01 00:00:00

  • Failure to rescue and mortality after reoperation for abdominal aortic aneurysm repair.

    abstract:OBJECTIVES:Complications after abdominal aortic aneurysm (AAA) repair resulting in reintervention increase mortality risk, but have not been well studied. Mortality after reintervention is termed failure to rescue and may reflect differences related to quality management of the complication. This study describes the re...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Mell MW,Kind A,Bartels CM,Smith MA

    更新日期:2011-08-01 00:00:00

  • Delayed aortic aneurysm enlargement due to endotension after endovascular abdominal aortic aneurysm repair.

    abstract::Abdominal aortic aneurysm (AAA) enlarges after successful endovascular repair, because of persistent blood flow within the aneurysm sac, or endoleak. In the absence of detectable endoleak, AAA may still expand, in part because of persistent pressurization within the excluded aneurysm, or endotension. We report three p...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Lin PH,Bush RL,Katzman JB,Zemel G,Puente OA,Katzen BT,Lumsden AB

    更新日期:2003-10-01 00:00:00

  • Transgression confession: ethics of medical error disclosure.

    abstract::Complications of medicine are like the sand traps in golf courses. They are regrettable, cannot be completely avoided even by the best, and the real skill lies in solving the problems they present. Dr Al Mighty told a resident to ignore a barely elevated temperature in a postoperative patient. "It is nothing worthy of...

    journal_title:Journal of vascular surgery

    pub_type: 社论


    authors: Jones JW,McCullough LB

    更新日期:2013-12-01 00:00:00

  • Endovascular exclusion of descending thoracic aortic aneurysms and chronic dissections: Initial clinical results with the AneuRx device.

    abstract:OBJECTIVE:The objective of this study was to analyze a single-center experience in which descending thoracic aortic aneurysms (TAAs) were treated with a new self-expanding endovascular prosthesis (Medtronic AVE). METHODS:Twenty-six patients (13 men, 13 women) with American Society of Anesthesiology grades II to IV and...

    journal_title:Journal of vascular surgery

    pub_type: 临床试验,杂志文章


    authors: White RA,Donayre CE,Walot I,Lippmann M,Woody J,Lee J,Kim N,Kopchok GE,Fogarty TJ

    更新日期:2001-05-01 00:00:00

  • Development of drug-coated balloon for the treatment of multiple peripheral artery segments.

    abstract:OBJECTIVE:Peripheral artery disease is the second most common cardiovascular disease. It can often occur in complex form when there is a presence of long, diffuse, and multiple lesions. Current treatments use either single long drug-coated balloons (DCBs) or multiple DCBs; however, treatment success is limited. The pur...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Anderson JA,Lamichhane S,Fuglsby K,Remund T,Pohlson K,Evans R,Engebretson D,Kelly P

    更新日期:2020-05-01 00:00:00

  • Suprarenal placement of vena caval filters: indications, techniques, and results.

    abstract::Preferred treatment for thromboembolism when heparin fails or is contraindicated is infrarenal inferior vena cava (IVC) interruption. In the present study suprarenal Greenfield filters were placed in 11 patients in whom routine infrarenal IVC interruption would have been inadequate therapy. As identified by IVC venogr...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Orsini RA,Jarrell BE

    更新日期:1984-01-01 00:00:00

  • Remodeling of experimental arteriovenous fistula with increased matrix metalloproteinase expression in rats.

    abstract:OBJECTIVE:Venous dilatation and wall thickening are part of the maturation of an arteriovenous fistula (AVF). However, the underlying mechanism of AVF remodeling remains unknown. We therefore studied whether matrix remodeling elicited by matrix metalloproteinases (MMPs) may contribute to AVF maturation. METHODS:A femo...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Chan CY,Chen YS,Ma MC,Chen CF

    更新日期:2007-04-01 00:00:00

  • Neutrophil-lymphocyte ratio as a prognostic marker of outcome in infrapopliteal percutaneous interventions for critical limb ischemia.

    abstract:BACKGROUND:Endovascular intervention has become a frequently used treatment of critical limb ischemia (CLI) in recent times. The recent Bypass vs Angioplasty in Severe Ischaemia of the Leg (BASIL) trial consensus recommended endovascular treatment as a first-line treatment in patients who have a life expectancy that wa...

    journal_title:Journal of vascular surgery

    pub_type: 杂志文章


    authors: Chan C,Puckridge P,Ullah S,Delaney C,Spark JI

    更新日期:2014-09-01 00:00:00