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Preoperative evaluation of abdominal aortic aneurysms: is there a need for aortography?

A comparison was made between angiography (AI), computer tomography (CT) and ultrasound (US) in the preoperative evaluation of 85 consecutive patients with abdominal aortic aneurysm. A total of 63 AI, 24 CT and 43 US were performed. It is concluded that the diagnostic accuracy in identifying aneurysms is higher for CT and US than for AI. AI and CT provide more correct data concerning the anatomy in the region of the renal arteries than US. We suggest that a non-invasive technique should be used for preoperative verification of the diagnosis. AI should only be used when the upper limit of the aneurysm and the relation to the renal arteries cannot be defined by non-invasive methods and, furthermore, in all cases with clinical signs of stenotic disease of the iliac arteries.