Endoleak after aortic stent graft repair: Diagnosis by color duplex ultrasound scan versus computed tomography scan

Sato, Dean T.; Hoff, Charles D.; Gregory, Roger T.; Robinson, Kevin; Carter, Kathy A.; Herts, Brian R.; Vilsack, Holly B.; Gayle, Robert G.; Parent, F. Noel; DeMasi, Richard J.; Meier, George H.

doi:10.1016/s0741-5214(98)70091-6

Cited by 159 publications

(117 citation statements)

References 16 publications

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“…To our knowledge no study has compared the value of CT angiography as an alternative to DU in the follow-up of popliteal artery diseases. However, the majority of reports on DU performance to detect endoleaks after endovascular repair of abdominal aortic aneurysm [26][27][28][29][30][31] found inferior sensitivity and specificity compared to CT angiography. Nevertheless, contrast agents (Levovist) seem to increase the sensitivity of this color-flow DU, but with the risk of more false-positive results [32].…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of surgically excluded popliteal artery aneurysms with multi-slice CT angiography and Doppler ultrasound

et al. 2006

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The purpose of this study was to evaluate the role of multi-slice computed tomography (MSCT) angiography in the follow-up of popliteal artery aneurysms (PAAs) that have been operated on. Aneurysm exclusion and progression, graft patency and graft-related complications were analyzed. Fourteen patients with 21 surgically excluded PAAs were evaluated with MSCT angiography with slice thickness of 1.25 mm. The mean follow-up time was 67 months. MSCT demonstrated blood flow in six nonexcluded PAAs (24%), with an average increase in the diameter of 21 mm over time. Fifteen PAAs demonstrated no blood flow and revealed an average decrease of 7 mm in diameter. The origin of this residual perfusion was demonstrated, and collaterals were involved in five of six non-excluded PAAs. In addition, MSCT demonstrated three graft stenoses. Furthermore, two occluded grafts were visualized. Twenty-four percent of the patients after surgical exclusion of PAAs revealed residual perfusion within the aneurysmal sac during follow-up, with a significant increase in the aneurysmal size with MSCT. Moreover, evaluation of the graft patency could also be done as could demonstration of anastomotic abnormalities. Thus, MSCT might be considered as a new tool to evaluate residual collateral feeding of popliteal aneurysmal sac and could be useful in identification and localization of feeding vessels.

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Section: Discussionmentioning

confidence: 99%

Long-term follow-up of surgically excluded popliteal artery aneurysms with multi-slice CT angiography and Doppler ultrasound

et al. 2006

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“…It is limited by the patient's body habitus, overlying bowel gas, technician's skill, and inconsistent ability to image the proximal infrarenal aorta. [2][3][4][5][6] A CT scan does not image flow directly. High attenuation structures, such as calcium or residual radiopaque contrast, may simulate abnormal blood flow into extravascular spaces, as seen with endoleaks.…”

Section: Discussionmentioning

confidence: 99%

“…The two modalities are complementary, and when performed in an accredited vascular laboratory by experienced technologists, duplex ultrasound is a highly sensitive and specific method of detecting extrastent flows. [2][3][4][5][6] We present a case of extrastent contrast without evidence of active extravasation seen on spiral CT at 40 hours postoperatively.…”

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confidence: 88%

“Pseudoendoleak”— Residual Intrasaccular Contrast after Endovascular Stent-Graft Repair

et al. 2002

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ࡗ ࡗPurpose: To present a unique demonstration of postoperative perigraft contrast masquerading as an endoleak following endovascular abdominal aortic aneurysm (AAA) repair. Case Report: A 66-year-old man underwent endovascular stent-graft repair of a 4.6-cm infrarenal AAA. The procedure was uncomplicated, and intraoperative completion angiography demonstrated good proximal and distal fixation of the stent-graft without an endoleak. A spiral computed tomographic (CT) angiogram obtained on postoperative day 2 revealed a large amount of extrastent contrast along the posterior aspect of the aneurysm sac. This defect had the appearance of an endoleak, but it was also present on the noncontrast images. A color-flow duplex examination performed on the same day showed a widely patent stent-graft with no evidence of extrastent flow. Conclusions: Contrast trapped in the aneurysm sac during endovascular aneurysm repair may be misinterpreted as an endoleak on postprocedural CT scans. ''Pseudoendoleaks'' can be distinguished from true endoleaks by examination of prebolus, noncontrast CT images, as well as by duplex ultrasound scanning. J Endovasc Ther 2002;9:119-123

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“…In addition, satisfactory images cannot be obtained in some patients because of technical inability (ie, obesity or excessive intestinal gas). A review of the CDU studies from multiple centers for the EnACT stent-graft trial (Sato et al, 1998), revealed that most of the studies were suboptimal in the evaluation for endoleaks. Although approximately 90% of the studies were technically possible, as indicated with satisfactory Bmode images, complete evaluation for endoleaks as outlined in the methods described was obtained in only 19% of the studies.…”

Section: Color Duplex Ultrasound Limitationsmentioning

confidence: 99%

Color-Doppler Ultrasonography in the Monitoring of Endovascular Abdominal Aortic Aneurysm Repair

Norberto¹,

Taylor²,

Vaquero³

2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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Endoleak after aortic stent graft repair: Diagnosis by color duplex ultrasound scan versus computed tomography scan

Abstract: Although most of the CDU studies were technically suboptimal, the CDUs reliably identified endoleaks with an excellent sensitivity and a negative predictive value as compared with CT scans.

Cited by 159 publications

References 16 publications

Long-term follow-up of surgically excluded popliteal artery aneurysms with multi-slice CT angiography and Doppler ultrasound

Long-term follow-up of surgically excluded popliteal artery aneurysms with multi-slice CT angiography and Doppler ultrasound

“Pseudoendoleak”— Residual Intrasaccular Contrast after Endovascular Stent-Graft Repair

Color-Doppler Ultrasonography in the Monitoring of Endovascular Abdominal Aortic Aneurysm Repair

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