Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know

Eur Radiol. 2010 Apr;20(4):1011-22. doi: 10.1007/s00330-009-1603-3. Epub 2009 Sep 30.


Purpose: Endovascular aneurysm repair of the infrarenal or thoracic aorta has been shown to be a less invasive alternative to open surgery. A combined aneurysm of the thoracic and abdominal aorta is complex and challenging; the involvement of renal and/or visceral branches requires new treatment methods.

Methods: A hybrid approach is currently an accepted alternative to conventional surgery. Renal and/or visceral revascularisation enables subsequent stent-graft placement into the visceral portion of the aorta.

Results: Knowledge of the surgical procedure and a precise assessment of the vascular morphology are crucial for pre-procedural planning and for detection of post-procedural complications. Multi-detector computed tomography angiography (MDCTA) combined with two- and three-dimensional (2D and 3D) rendering is useful for pre-interventional planning and for the detection of post-procedural complications. Three-dimensional rendering allows proper anatomical analyses, influencing interventional strategies and resulting in a better outcome.

Conclusions: With the knowledge of procedure-specific MDCTA findings in various vascular conditions, the radiologist and surgeon are able to perform an efficient pre-interventional planning and follow-up examination. Based on our experience with this novel technique of combined open and endovascular aortic aneurysm treatment, this pictorial review illustrates procedure-specific imaging findings, including common and rare complications, with respect to 2D and 3D post-processing techniques.

MeSH terms

  • Angiography / methods
  • Aortic Aneurysm, Abdominal / diagnostic imaging*
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging*
  • Aortic Aneurysm, Thoracic / surgery*
  • Humans
  • Plastic Surgery Procedures / methods*
  • Renal Artery / diagnostic imaging
  • Renal Artery / surgery
  • Surgery, Computer-Assisted / methods
  • Tomography, X-Ray Computed / methods*
  • Vascular Surgical Procedures / methods*