Computed Tomography and Ultrasound in Follow-up of Patients after Endovascular Repair of Abdominal Aortic Aneurysm

Systematic Review: Emergency Department Bedside Ultrasonography for Diagnosing Suspected Abdominal Aortic Aneurysm

“…There was also a wide range of prevalence of AAA across studies. It has been shown that increased body mass index decreases the sensitivity of the physical examination for the detection of AAA 59 ; Elkouri et al 60 also reported difficulty in obtaining adequate images in patients with increased body mass index. Only Rowland et al 41 mentioned patients' body mass indices, but did not specifically analyze accuracy within the AAA subgroup.…”

Vascular ultrasonography for follow-up of endovascular repair of abdominal aorta aneurysms

“…While published specificity rates for detection of endoleaks with Doppler ultrasonography are high (89%-97%), 21 the sensitivity and diagnostic power of Doppler US for detecting endoleaks is still debatable, when compared with angiotomography. 11,[22][23][24][25][26][27][28][29][30] Some studies, 11,[22][23][24][25] such as one conducted by Collins et al, 11 have reported 85% positive predictive values, whereas others [26][27][28][29][30] found ultrasonography to be less sensitive than tomography, as was the case of Ashoke et al, 30 who observed sensitivity of 70% in their study. In our study, four patients had endoleaks well-tolerated and, apparently, increase the sensitivity of ultrasonography.…”

Endovascular Repair: Radiation Risks

“…Therefore, various protocols for diagnostic / planning and postoperative follow-up imaging have been proposed to reduce both radiological and renal function deterioration risks. Dose reducing protocols related to post-operative imaging can be divided in three main groups: -application of less intensive follow-up procedures, including an optimized temporal spacing between CT scans (Dias, et al, 2009;Go, et al, 2008;Verhoeven, et al, 2011;White & McDonald, 2010;Zhou, 2011), -optimization of the CT scanning parameters (Diehm et al, 2008;Iezi et al, 2006Iezi et al, ,2009Kalef-Ezra et al, in press;Kirby et al, 2007;Macari et al, 2006;Nakayama, et al, 2006;Sommer, et al, 2010;Wintersperger, et al, 2005), -replacement of CT imaging with alternative imaging / assessment techniques, that require lower or even no radiation dose, such as ultrasound or MRI imaging (Elkouri et al;, Manning, et al, 2008Sternbergh, et al, 2008;Ten Bosch, et al;Tomlinson, et al, 2007Tomlinson, et al, , 2009Truijers, et al, 2009). The application of the life-long protocol for AAA management at IUH with optimized postoperative CT parameters resulted in a cumulative effective dose of almost 60 mSv (KalefEzra, in press), which leads to a 0.2% excess life-time mortality, using the 3.5% per Sv risk factor.…”