3D Contrast Enhanced Ultrasound for Detecting Endoleak Following Endovascular Aneurysm Repair (EVAR)

Abbas, Abeera; Hansrani, Vivak; Sedgwick, N; Ghosh, Jonathan; McCollum, Charles

doi:10.1016/j.ejvs.2014.02.002

Cited by 63 publications

(71 citation statements)

References 22 publications

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“…In the present case, the Doppler US and CEUS surveillance post-EVAR were sufficient to diagnose the presence of a leak at the level of the prostheses and to quantify the arterial flow inside the leak, as affirmed in similar recent literature reports [20][21][22][23]. Informations about the haemodynamic of the leak are of particular interest as a high flow leak requires immediate treatment.…”

Section: Discussionsupporting

confidence: 57%

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The use of Doppler ultrasonography for pre- and post-surgery monitoring of abdominal aortic aneurysm. Case report.

et al. 2016

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A 75 year old male patient was monitored for 3 years by Doppler Ultrasonography (US) for an abdominal aorta aneurysm (AAA). Because the aneurysm increased significantly, an aortic prosthesis was installed via an endovascular procedure. After one month of post-surgery monitoring, both Doppler US exam and contrast enhancement US (CEUS) suspected the presence of a leak at the level of the prosthesis. A new surgical procedure was scheduled and intraoperative arteriography confirmed an endoleak type II. Although not always able to specify the correct type of linkage, CEUS remains a reliable method for investigating the postoperative complications of AAA.

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Section: Discussionsupporting

confidence: 57%

“…Actually standard echography is considered as insufficient for direct use but CEUS has reliability and specificity to be a correct alternative to CT angiography [21,22]. Only if we consider that CEUS avoids potential induced nephropathies caused by repeated ionizations, the alternative is suitable.…”

Section: Discussionmentioning

confidence: 99%

The use of Doppler ultrasonography for pre- and post-surgery monitoring of abdominal aortic aneurysm. Case report.

et al. 2016

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“…This imaging modality involves the use of magnetic field emitters to place and orientate a sonographic probe. In a pilot study of 23 patients, Abbas et al compared the abilities of three diagnostic methods (three‐dimensional CEUS, two‐dimensional CEUS, and CTA) to detect an endoleak. EL‐II were identified in 18 patients, and only three‐dimensional CEUS could identify their inflow and outflow vessels.…”

Section: Discussionmentioning

confidence: 99%

Advantages of contrast‐enhanced ultrasonography over computed tomography for the detection of persistent type II endoleak after embolization: A case report

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Godoy

et al. 2016

J of Clinical Ultrasound

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The aim of this case report is to describe the use of contrast-enhanced ultrasonography in the detection of a type II endoleak after prior embolization with Onyx. A 74-year-old male patient with hypertension previously underwent endovascular repair of a 7.1-cm infrarenal aortic aneurysm. CT angiography surveillance revealed a type II endoleak associated with aneurysm sac expansion. Selective transarterial embolization of the endoleak was performed, but it was not possible to detect the persistent endoleak using CT angiography because of image artifacts caused by Onyx. Contrast-enhanced ultrasonography enabled us to detect the persistent endoleak in this patient. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:522-526, 2016.

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“…The use of Computed Tomography Angiography (CTA), which is currently recommended for the follow-up of patients undergoing EVAR, puts the patients at risk of receiving high doses of ionizing radiation and exposes them to the repetitive impact of nephrotoxic X-ray contrast [1, 2]. …”

mentioning

confidence: 99%

“…High-resolution contrast-enhanced ultrasound (CEUS) is one of the alternative methods used to detect and characterize endoleaks [1, 2]. The advent of CEUS imaging utilizing sulfur hexafluoride microbubbles as a contrast agent improved the resolution and sensitivity of microvessel visualization.…”

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confidence: 99%

Superb Micro-vascular Imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after Endovascular Aneurysm Repair (EVAR)

et al. 2018

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PurposeThe aim of the study was to assess the effectiveness of Superb Micro-vascular Imaging (SMI) as an alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR).Materials and methodsFrom May 2015 to January 2017, 30 patients underwent post-EVAR follow-up with Color Doppler Ultrasound (CDUS), CEUS, SMI, and CTA examinations. Aneurysmal sac diameter and graft patency were evaluated; endoleaks were identified and classified. Sensitivity, specificity, and accuracy values were calculated for each of the four diagnostic methods of endoleak detection. A percentage of agreement and Cohen’s Kappa coefficient were calculated for comparison of methods in terms of endoleak identification.ResultsCTA revealed fifteen endoleaks (50%): three type Ia, nine type II, and three type III. The sensitivity of CDUS, CEUS, and SMI relative to CTA was 27%, 100%, and 100%, respectively. Specificity was 93%, 93%, and 93%, respectively. Accuracy was 60%, 97%, and 97%, respectively. There were no differences between SMI and CEUS in terms of sensitivity, specificity, or accuracy (100%, 93%, and 97%). We do not observe statistically significant differences between CTA, CEUS, and SMI concerning endoleak identification ability. The weakest method in endoleak identification was CDUS.ConclusionsThe analysis showed that SMI is effective, repeatable, and comparable with the CEUS modality in identification endoleaks after EVAR; it may be considered as a potential tool to monitor patients after EVAR implantation, especially those with renal insufficiency or with an allergy to any contrast media.

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3D Contrast Enhanced Ultrasound for Detecting Endoleak Following Endovascular Aneurysm Repair (EVAR)

Abstract: 3D CEUS may be more sensitive to endoleak following EVAR than either 2D CEUS or CTA.

Cited by 63 publications

References 22 publications

The use of Doppler ultrasonography for pre- and post-surgery monitoring of abdominal aortic aneurysm. Case report.

The use of Doppler ultrasonography for pre- and post-surgery monitoring of abdominal aortic aneurysm. Case report.

Advantages of contrast‐enhanced ultrasonography over computed tomography for the detection of persistent type II endoleak after embolization: A case report

Superb Micro-vascular Imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after Endovascular Aneurysm Repair (EVAR)

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