Iliac Artery Tortuosity, Calcification and Abnormal Shape Augment Aortic Aneurysm Anatomy in Predicting Complications After Endovascular Aneurysm Repair

Abstract Post-surgical complications following endovascular aneurysm repair (EVAR) remain a risk, arising from technical difficulties imposed by highly calcified or tortuous iliac arteries. Automated methods enable segmentation of the artery to potentially better define perioperative risk prediction. This study uses imaging software characterise segmental anatomy and aims establish if abnormalities can predict adverse outcomes EVAR. Pre-operative clinical information CT angiograms were obtained 189 patients who underwent elective Patients followed for up 3 years detect stent-related mortality. Aneurysm morphology was manually measured on scans. measurements vessel shape, curvature calcification taken multiple subdivisions common external Logistic regression models trained assess influence outcomes. Combining aortic features improved predictions both morbidity over using either alone. Models predicting death early late stent had respective areas under curve (AUCs) 0.761, 0.935 0.833. Iliac significant predictors poor morphological assessment improves prediction The power implies that regional arteries are important when assessing surgical risk. allows further rationalisation selection individuals treatment may improve patient