Virtual stenting of iliac arteries: a new technique for choosing stents and stent-grafts by means of 3D rotational angiography. Preliminary data.

PURPOSE:Virtual stenting (VS) is a new tool in the 3D processing work station of rotational angiography (RA) systems. This tool enables the 3D visualization of a stent or stent-graft in the site of a stenotic, obstructive or aneurysmatic lesion to be treated. We report the preliminary results obtained with this software in the treatment of segmental stenotic, obstructive or aneurysmal lesions of the iliac artery. MATERIALS AND METHODS:Seventeen patients under-went rotational angiography and 3D reformations for one or more stenoses (19 cases), obstructive lesions (2 cases) or aneurysms (2 cases) of the common and/or external iliac artery and were treated with stents in 22/23 of cases. In all cases, the VS tool was applied to the stenotic-obstructive lesion on the identified on the 3D angiogram obtained before the stenting procedure. RESULTS:The measurements of the stents/stents-grafts (length, proximal and distal diameter) provided by the tool were compared to those of the stent deployed. In 22/23 procedures, the measurements of virtual stenting and those of the deployed stent showed a good level of concordance. The system failed to provide correct measurements in only one long and tortuous iliac aneurysm. CONCLUSIONS:The ''virtual stenting'' tool proved to be reliable and fast, and enabled a more objective selection of the stent to be deployed on a stenotic-obstructive lesion in almost all cases. In cases of aneurysms of marked tortuosity, the system tends to suggest an inappropriate stent. The possibility of manually defining the optimal stent path within the aneurysmal sac might be useful.