Stent Graft Sizing for Endovascular Abdominal Aneurysm Repair Using Open Source Image Processing Software

Ann Vasc Surg. 2021 Feb:71:411-418. doi: 10.1016/j.avsg.2020.08.126. Epub 2020 Sep 3.

Abstract

Introduction: An important step to reach a favorable outcome of abdominal endovascular aneurysm repair (EVAR) is preoperative sizing of the stent graft using computed tomography angiography (CTA) images of the abdominal aorta. A variety of costly image processing software options is available to obtain the necessary aortic measurements. A package that can be used for EVAR sizing is OsiriX Lite®-an open source, freely downloadable image processing option. This study assesses the concurrent validity of OsiriX Lite® when compared with commercially available 3Mensio Vascular® and Siemens Syngo.via®.

Methods: CTA scans of 20 patients that underwent EVAR for abdominal aneurysm were selected, 10 elective and 10 ruptured. For each scan, 6 observers determined 20 parameters needed for proper stent graft sizing, 2 using Osirix Lite®, 3 using 3Mensio Vascular®, and 1 using Siemens Syngo.via®. For each parameter, an intraclass correlation coefficient (ICC) and a P-value were calculated. Interrater agreement was interpreted using the Koo and Li Guidelines. Time needed to perform EVAR planning was compared.

Results: Overall interrater agreement between the 3 sizing options was found to be either "good" or "moderate" for 16 out of 20 parameters (80%). Time needed to perform EVAR planning was not significantly different for Osirix Lite® (568 sec) when compared with 3Mensio Vascular® (603 sec) or Siemens Syngo.via® (659 sec) with a P-value of 0.88.

Conclusions: The authors conclude that Osirix Lite® is an accurate and time-effective image processing option for preoperative sizing of an EVAR stent graft when matched to 3Mensio Vascular® and Siemens Syngo.via®.

Publication types

  • Comparative Study
  • Validation Study

MeSH terms

  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / surgery*
  • Aortography*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Clinical Decision-Making
  • Computed Tomography Angiography*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Humans
  • Observer Variation
  • Predictive Value of Tests
  • Prosthesis Design
  • Radiographic Image Interpretation, Computer-Assisted*
  • Reproducibility of Results
  • Retrospective Studies
  • Software*
  • Stents*
  • Treatment Outcome