iothalamate-meglumine and Aortic-Aneurysm

Computerized tomographic scanning is being used with increasing frequency for the detection of abdominal aortic prosthetic complications. Although computerized tomography remains a very precise method for direct imaging of the retroperitoneal space, the interpretation of a postoperative computerized tomographic scan is limited by the absence of any information on the normal appearance of the routine uncomplicated aortic graft. To study the normal tissue incorporation of aortic grafts, 29 patients were evaluated with periodic postoperative computerized tomographic scans. Seventeen patients had aortoiliac occlusive disease and 12 had aneurysmal disease. No patients who had reoperation were included and all patients had a normal postoperative course. Computerized tomographic scans were obtained in the early (mean 7 days), intermediate (mean 48 days), and late (mean 102 days) postoperative periods. A variable amount of perigraft hematoma was always present on the initial computerized tomographic scan. Perigraft air was seen in only four patients in the early study. Graft incorporation appeared complete in these patients by 48 days, although minimal hematoma persisted in one patient. This study provides baseline data on the appearance and timing of aortic graft incorporation which should facilitate subsequent computerized tomographic detection of aortic graft complications.

Topics: Aged; Aorta, Abdominal; Aortic Aneurysm; Blood Vessel Prosthesis; Female; Follow-Up Studies; Humans; Iliac Artery; Iothalamate Meglumine; Male; Polyethylene Terephthalates; Polytetrafluoroethylene; Prospective Studies; Tomography, X-Ray Computed; Vascular Diseases

The authors conducted a retrospective analysis of the CT findings in 29 consecutive patients being studied to detect complications of aortofemoral bypass surgery. Presenting symptoms included fever in 22 (76%), gastrointestinal bleeding in 2 (7%), a pulsating mass in 3 (10%), jaundice in 1 (3%), and back pain in 1 (3%). The complications observed most frequently were groin infection in 7 (24%), abdominal perigraft abscess in 11 (38%), pseudoaneurysm in 6 (21%), aortoenteric fistula in 3 (10%), and lymphocystic hematoma in 3 (10%). There were no false negatives, and the overall accuracy and sensitivity of CT in detecting complications was 100%. The authors recommend that CT be performed prior to angiography or surgery whenever an abscess, pseudoaneurysm, or aorto-enteric fistula is suspected.

Topics: Abscess; Aorta, Abdominal; Aortic Aneurysm; Blood Vessel Prosthesis; Femoral Artery; Fever; Gastrointestinal Hemorrhage; Humans; Iothalamate Meglumine; Postoperative Complications; Retrospective Studies; Surgical Wound Infection; Tomography, X-Ray Computed