Computed Tomographic Angiography in Postoperative Evaluation of Abdominal Aortic Aneurysms: Pearls, Pitfalls, and Complications.

Abdominal aortic aneurysm (AAA) is a potentially life-threatening dilation of the aorta, with rupture posing the greatest risk. Surgical management includes both open repair and endovascular aneurysm repair (EVAR), with computed tomography angiography (CTA) serving as the gold standard for preoperative planning, postoperative follow-up, and complication detection. This pictorial review illustrates key imaging features and common complications after AAA repair, including endoleak, graft thrombosis, device migration, and aortoenteric fistulas. It also outlines the imaging appearances of different graft systems (Anaconda™, Ovation™, and snorkel stents) used in EVAR, as well as the classic features of open surgical repair. Given the complexity of graft designs and the spectrum of potential complications, radiologists play a central role in identifying adverse outcomes and ensuring timely clinical intervention. Familiarity with post-treatment imaging findings is essential for accurate interpretation, complication recognition, and improved patient outcomes.