CT angiography for the assessment of EVAR complications: a pictorial review

Abstract

Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complications. CT angiography is the gold standard diagnostic technique for preprocedural planning and postprocedural surveillance. EVAR needs long-term follow-up due to the high rate of complications. Complications can be divided in endograft device-related and systemic complications. The purpose of this article is to review the CT imaging findings of EVAR complications and the key features for the diagnosis.

Brachial artery aneurysm after hemodialysis fistula ligation: Case reports and review of literature

“…The use of long-term immunosuppressive therapy is another determinant of brachial artery aneurysm because it results in vascular remodeling of the three layers of the vessel wall due to the establishment of a cytokine-mediated inflammatory process [ 12 ]. Diagnostics uses different techniques such as duplex ultrasonography, computed tomography, magnetic resonance imaging, and digital subtraction angiography [ [13] , [14] , [15] , [16] ]. Regarding AVF ligation after transplantation, some authors advise against it if the fistula is functioning and should be reserved for hand ischemia cases, risk of pseudo-aneurysm rupture, severe venous hypertension or significant high-output heart failure [ 17 , 18 ].…”

A rare case of aortic endograft infection by Francisella tularensis: A case report

“…Patients usually present fever (71.4 %), back pain (57.1 %), and sometimes weight loss associated with inflammation and leukocytosis in approximately two-thirds of cases [ 4 , 14 , 15 ].…”

“…Only 26.7 % of blood cultures could be positive [ 3 ]. CT scan could show mesenteric fat stranding adjacent to the stent graft, perigraft fluid collections, abnormal enhancement, air bubbles and/or adjacent structures erosion [ 14 , 16 ]. Technetium-labeled WBC scanning is useful for aortic graft infection diagnosis, particularly in the low-grade stages [ 17 ].…”

Advantages of Photon-Counting Detector CT in Aortic Imaging

“…However, EVAR can lead to endoleaks (ELs), which are the persistence of blood flow outside the graft into the aneurysm sac, posing the risk of growth and rupture ( Supplementary Table S1 ). ELs was the most common complication (53% of all complications), with an incidence of 11.7% [ 34 , 35 ]. Traditional CT protocols include unenhanced, arterial-phase, and venous/delayed-phase scans to assess the blood vessels and stent grafts [ 36 , 37 , 38 ].…”