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Erschienen in:
01.06.2014 | Clinical Investigation
Semiautomatic Sizing Software in Emergency Endovascular Aneurysm Repair for Ruptured Abdominal Aortic Aneurysms
Erschienen in: CardioVascular and Interventional Radiology | Ausgabe 3/2014
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Purpose
In emergency endovascular repair (EVAR) of ruptured aneurysms of the aorta (rAAA), anatomical suitability must be determined. Semiautomatic three-dimensional assessment of the aortoiliac arteries has the potential to standardise measurements. This study assesses the fitness for purpose of such a semiautomatic approach for rAAA and determined interobserver agreement on suitability.
Materials and Methods
Interobserver study with six trained observers (4 vascular surgeons, 2 radiologists) blindly assessing preoperative computed tomography angiography scans of 50 consecutive patients with rAAA. A central lumen line (CLL) was generated, and perpendicular diameters, length along the CLL, and EVAR suitability were determined using dedicated sizing software (3mensio; 3mensio Vascular; Bilthoven, The Netherlands). Success of generating a CLL, time of assessment, and interobserver agreement was determined.
Results
In the majority of the patients (median 76 %, range 64–78 %), a CLL was semiautomatically generated. The median duration of CLL generation and performance measurements was 7.5 min (interquartile range 5.5–10.6). Agreement on suitability was moderate for the entire group (Fleiss’ κ = 0.55, confidence interval 0.48–0.62) and ranged from moderate to good (Cohen’s κ = 0.40–0.72) between observer pairs.
Conclusion
Assessing EVAR suitability of rAAA patients using dedicated sizing software is possible in the majority of patients. The measurements can be performed in a reasonable amount of time, and the agreement of suitability for EVAR in patients with rAAA is moderate. Improvements and additional research are necessary to replace the current axial measurement.