A Simple Technique to Improve the Accuracy of Proximal AAA Endograft Deployment

PURPOSE: To report a technique for overcoming the positioning errors caused by angulation and rotation of the proximal aortic neck when anteroposterior fluoroscopic imaging is used during endograft deployment. TECHNIQUE: Aortic neck angulation and rotation were measured preoperatively using spiral computed tomographic angiography in sagittal and axial projections. Before proximal graft deployment, the proximal end of the endograft was centered in the field of view, and the position of the C-arm was adjusted to the aortic neck angulation. Using this technique, optimal positioning of the endograft relative to the true position of the renal arteries can be achieved. CONCLUSIONS: C-arm angulation and rotation is helpful in facilitating perfect positioning for an optimal seal between the endograft and the infrarenal aortic neck.