Endovascular Aortic Repair Follow up Protocol Based on Contrast Enhanced Ultrasound Is Safe and Effective

Chisci, Emiliano; Harris, Linda M.; Guidotti, Azzurra; Pecchioli, Angelica; Pigozzi, Clara; Barbanti, Enrico; Ercolini, Leonardo; Michelagnoli, Stefano

doi:10.1016/j.ejvs.2018.03.006

Cited by 22 publications

(13 citation statements)

References 25 publications

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“…Our series showed a 1.7% 30-day mortality rate and a 7.0% long-term mortality rate, most of which were not related to AAA [6,17]. Following current guidelines, follow-up with CTA was done paying special attention to aneurysm size progression and endoleaks [29,30]. However, because of concerns of repeated exposure to radiation and nephrotoxic contrast, we started to include DUS surveillance during long-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Elective Endovascular Aneurysmal Repair for Abdominal Aortic Aneurysms in Jordan

Janho

Rashaideh

Shishani

et al. 2019

VSI

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PurposeThe outcomes of endovascular aneurysmal repair (EVAR) for infrarenal abdominal aortic aneurysms (AAAs) in the Middle East have rarely been reported. We analyzed the outcomes of EVAR in a Jordanian population.Materials and MethodsWe conducted a retrospective review of the medical records of patients with infrarenal AAA who were treated with elective EVAR between January 2004 and January 2017 at a single center in Jordan. Patient characteristics, anatomical characteristics, procedural details, and early and late postoperative outcomes were analyzed.ResultsA total of 288 patients (mean age, 70 years; 77.8% males) underwent EVAR for infrarenal AAA (median aneurysm size, 64 mm). Bifurcated endografts were used in 265 patients, and aorto-uni-iliac devices were used in 22 patients. Successful endograft deployment was achieved in all patients with no open conversion. Early complications included localized groin hematoma in 15, femoral artery dissection in 4, wound infection in 3, and seroma in 3 patients. With a mean follow-up of 60 months, 50 endoleaks were detected, including 9 type I, 38 type II, and 3 type III. Seven patients had unilateral graft limb occlusion. The 30-day mortality was 1.7%, and long-term mortality was 7.0%, mostly due to non-AAA-related causes.ConclusionEVAR was safely performed in Jordanian patients with minimal complications. However, long-term surveillance is important due to the risk of endoleaks and consequent intervention.

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Section: Discussionmentioning

confidence: 99%

“…However, because of concerns of repeated exposure to radiation and nephrotoxic contrast, we started to include DUS surveillance during long-term follow-up. Some studies have reported that DUS showed similar detection of endoleaks as CT as well as a lower cost and avoidance of the ionizing radiation and contrast [10,12,30].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Elective Endovascular Aneurysmal Repair for Abdominal Aortic Aneurysms in Jordan

Janho

Rashaideh

Shishani

et al. 2019

VSI

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“…The CEUS presents detailed vascular morphology and enables real-time quantification of blood flow [34], which in some studies resulted in a higher specificity than that of CTA in endoleak classification [35]. In a recent retrospective study by Chisci et al The CEUS was used as a reference method of follow-up [36]. In their material 318 CEUS examinations were performed with no procedure-related complications and allowed for 90% reduction in the number of CTAs, thereby reducing radiation exposure for patients.…”

Section: Imaging Methodsmentioning

confidence: 99%

Contemporary imaging methods for the follow-up after endovascular abdominal aneurysm repair: a review.

Kazimierczak

Serafin

Kazimierczak

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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Abdominal aortic aneurysm (AAA) is defined as a localized enlargement of the aortic cross-section where the diameter is greater than 3 cm or more than 50% larger than the diameter in a normal segment. The most important complication of AAA is rupture, which, if untreated, results in mortality rates of up to 90%. Conventional open surgical repair is associated with significant 30-day mortality. Endovascular aneurysm repair (EVAR) is a significantly less invasive procedure; it is related to a lower early mortality rate and a lower number of perioperative complications. Although EVAR is a minimally invasive technique, lifelong follow-up imaging is necessary due to possible late complications including endoleak, recurrent aneurysm formation, graft infection, migration, kinking and thrombosis. The total rate of complications after EVAR is estimated at approximately 30%, and the rate of complications that require intervention is 2–3%. Early detection and progression analysis of such situations is crucial for proper intervention.

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“…21). As a result, CEUS allows a reduction of the number of CT angiography in surveillance and can reduce radiation hazard and complication related to iodinated contrast agent (7576). In most recently updated guidelines from European Federation of Societies for Ultrasound in Medicine and Biology, CEUS using this new USCA is recommended not only for the detection and characterization of endoleak but also for the follow-up of AAA endoleak with the strongest level of recommendation (77).…”

Section: Issues Related To Radiation and Contrast Materialsmentioning

confidence: 99%

Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Comprehensive Review

et al. 2019

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Abdominal aortic aneurysm (AAA) can be defined as an abnormal, progressive dilatation of the abdominal aorta, carrying a substantial risk for fatal aneurysmal rupture. Endovascular aneurysmal repair (EVAR) for AAA is a minimally invasive endovascular procedure that involves the placement of a bifurcated or tubular stent-graft over the AAA to exclude the aneurysm from arterial circulation. In contrast to open surgical repair, EVAR only requires a stab incision, shorter procedure time, and early recovery. Although EVAR seems to be an attractive solution with many advantages for AAA repair, there are detailed requirements and many important aspects should be understood before the procedure. In this comprehensive review, fundamental information regarding AAA and EVAR is presented.

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Endovascular Aortic Repair Follow up Protocol Based on Contrast Enhanced Ultrasound Is Safe and Effective

Cited by 22 publications

References 25 publications

Outcomes of Elective Endovascular Aneurysmal Repair for Abdominal Aortic Aneurysms in Jordan

Outcomes of Elective Endovascular Aneurysmal Repair for Abdominal Aortic Aneurysms in Jordan

Contemporary imaging methods for the follow-up after endovascular abdominal aneurysm repair: a review.

Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Comprehensive Review

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