Single-centre Prospective Comparison Between Contrast-Enhanced Ultrasound and Computed Tomography Angiography after EVAR

Perini, Paolo; Sediri, I.; Midulla, Marco; Delsart, Pascal; Mouton, S.; Gautier, C; Pruvo, Jean‐Pierre; Haulon, Stéphan

doi:10.1016/j.ejvs.2011.09.003

Cited by 75 publications

(41 citation statements)

References 23 publications

(28 reference statements)

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“…However, both DTA and CEUS correctly recognized the complications that required urgent treatment (9 patients) (Figure 2 and contrast medium for renal function. However, this technique could be affected by body morphology (obesity, ascites, bowel gas) and echo reflection from the stent graft, even if the latter is minimized by the use of contrast medium that increases the ultrasound signal [6] . Advantages of DTA are the possibility of imaging the graft in different planes and a radiation dose only slightly higher than of plain digital radiography but substantially lower than the dose required for high-and even lowdose CTA protocols.…”

Section: Discussionmentioning

confidence: 99%

“…Other major concerns about the frequent use of CTA in EVAR follow-up are the cost and the cumulative amount of exposure to ionizing radiation with potential lifetime cancer risk, though the latter seems questionable from a radiobiological point of view since EVAR patients are usually over 65 years of age [6,7] . Plain radiography, using a standardised protocol with antero-posterior and lateral projections is suitable for follow-up assessment of angulation, kinking, device migration, stent fractures and modular disconnections, including material fatigue.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the lack of radiation exposure or nephrotoxicity makes it attractive, especially combined with intravenous contrastenhancement [contrast-enhanced ultrasound (CEUS)], which has proven as accurate as CTA for detecting endoleaks and measuring abdominal aortic aneurysm diameter during EVAR follow-up. However, substantial interobserver variability, in measuring the diameter of aneurysm sacs and in detecting endoleaks, and lack of information about stent-graft integrity and migration, mean that DU has to be sustained by other diagnostic examinations for EVAR follow-up [6,8,9] . MRA with a blood pool contrast agent has been proposed as an accurate diagnostic tool for endoleak detection and in particular for type Ⅱ endoleaks, but has limitations, such as patient cooperation, clinical contraindications, scanner availability and cost [10,11] .…”

Section: Introductionmentioning

confidence: 99%

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Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

Mazzei¹,

Guerrini²,

Mazzei³

et al. 2016

WJR

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REVIEW 434Radiological features of uncommon aneurysms of the cardiovascular system COPYRIGHT © 2016 Baishideng Publishing Group Inc. Articles published by this Open-Access journal are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. SPECIAL STATEMENTAll articles published in journals owned by the Baishideng Publishing Group (BPG) represent the views and opinions of their authors, and not the views, opinions or policies of the BPG, except where otherwise explicitly indicated. WJR covers topics concerning diagnostic radiology, radiation oncology, radiologic physics, neuroradiology, nuclear radiology, pediatric radiology, vascular/interventional radiology, medical imaging achieved by various modalities and related methods analysis. The current columns of WJR include editorial, frontier, diagnostic advances, therapeutics advances, field of vision, mini-reviews, review, topic highlight, medical ethics, original articles, case report, clinical case conference (clinicopathological conference), and autobiography. INSTRUCTIONS TO AUTHORSWe encourage authors to submit their manuscripts to WJR. We will give priority to manuscripts that are supported by major national and international foundations and those that are of great basic and clinical significance.World Journal of Radiology is now indexed in PubMed, PubMed Central. I-IIIEditorial Board Author contributions: Mazzei MA, Guerrini S, Mazzei FG, Cioffi Squitieri N, Notaro D, de Donato G, Galzerano G, Sacco P and Setacci F made substantial contributions to conception and design of the study, and acquisition, analysis and interpretation of the data; Mazzei MA, Guerrini S and Setacci C contributed to drafting the article and revising it critically for important intellectual content; Mazzei MA, Volterrani L and Setacci C approved the final version to be published. AIM AND SCOPEInstitutional review board statement: The study was reviewed and approved by the University of Siena Institutional Review Board.Clinical trial registration statement: None.Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.Conflict-of-interest statement: None. RESULTS:Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33 (96.96%) patients and for the absence of complications in 127/130 (97.69%) patients; the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33 (57.57%) patients and for the absence of complications in 129/130 (99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivit...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

Mazzei¹,

Guerrini²,

Mazzei³

et al. 2016

WJR

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“…Angio-CT is considered the gold standard technique for the followup of AAA treated with EVAR [4]. It is the technique that has been used and continues to be used for the follow-up of these patients, although some authors advocate the use of other techniques such as MRI, Doppler ultrasound and Doppler ultrasound with enhancer that in some articles have shown greater precision for the detection and characterization of endoleaks [1].…”

Section: C)mentioning

confidence: 99%

“…It is the technique that has been used and continues to be used for the follow-up of these patients, although some authors advocate the use of other techniques such as MRI, Doppler ultrasound and Doppler ultrasound with enhancer that in some articles have shown greater precision for the detection and characterization of endoleaks [1]. CT angiography is not free from risks: use of ionizing radiation; an abdominal CT is approximately 10 mSv, equivalent to 4.5 years of natural radiation; and in the follow-up of these patients by this imaging modality, a dose of approximately 145-205 mSv is calculated at 5 years, which increases the risk of cancer [4]. It also uses contrasts that are nephrotoxic and that some patients end up developing hypersensitivity-allergy to contrasts, having described a frequency of 0.2 to 23% with the use of non-ionic contrasts [5][6][7].…”

Section: C)mentioning

confidence: 99%

Demystifying Endovascular Treatment of Abdominal Aortic Aneurysms: A Study by CT Angiography at a Tertiary Hospital

Razak¹,

Gupta²,

Meena³

2017

Angiol

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Aims & Objectives: The aim of this study is to compare the results of Doppler ultrasound with enhancer (EDP) versus CT angiography in the follow-up of patients with AAA(Abdominal-aortic-aneurysms) treated with EVAR(endovascular treatment), compare our results with the published literature and be able to validate the EDP in our hospital for the follow-up of AAAs treated by EVAR. Material & Methods:Of all patients with AAA treated by EVAR in our P.B.M hospital and to whom controls are being performed, 22 patients were randomly selected. The informed consent of the patients was obtained both for the performance of the control CT angiography and for the realization of the EDP. All of them underwent first a CT angiography and then the EDP. Two radiologists, one with 21 years of experience in EDP and the other radiologist with 3 years of experience in angio-CT, independently analyzed the results of the tests without knowing the results of the other test. Results:The mean diameter of the residual aneurysmal sac measured by EDP was 64.49 ± 15.12 mm (41.5-104) with a median of 63 mm and measured by angio-CT showed an average diameter of 59.41 ± 17.54 mm (30-108) with a median of 59 mm. Angio-CT identified a leak in 13.63% of the cases (n=3). The EDP demonstrated leakage in 31.82% of the cases (n=7), all type II; in 85.72% of cases (n=6) they corresponded to hyperdynamic type II leaks (before 100 seconds) and 14.28% of cases (n=1) corresponded to hypodynamic type II leaks (after 100 seconds). The values of sensitivity, specificity, positive and negative predictive value of the EDP were: sensitivity 100%, specificity 79%, positive predictive value 43% and negative predictive value 100%. Conclusion:The EDP is a technique that does not irradiate, it can be used in patients in whom the use of iodinated contaste is contraindicated. It is more specific than angio-CT for detecting low-flow leaks, being able to consider it as the first modality of imaging in the follow-up of patients after EVAR. The EDP allows an economic saving since the angio-CT or angio-MR are more expensive than the realization of an EDP. Our results are in agreement with those published by other authors, but we need a wider series to give greater statistical strength to our results. There is a perfect correlation between the two techniques when assessing the diameter of the residual aneurysmal sac.

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Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair

Abraha¹,

Luchetta

Florio³

et al. 2017

Cochrane Database of Systematic Reviews

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Background People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. Objectives To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS) in terms of sensitivity and specificity for endoleak detection after endoluminal abdominal aortic aneurysm repair (EVAR). Search methods We searched MEDLINE, Embase, LILACS, ISI Conference Proceedings, Zetoc, and trial registries in June 2016 without language restrictions and without use of filters to maximize sensitivity. Selection criteria Any cross-sectional diagnostic study evaluating participants who received EVAR by both ultrasound (with or without contrast) and CT scan assessed at regular intervals. Data collection and analysis Two pairs of review authors independently extracted data and assessed quality of included studies using the QUADAS 1 tool. A third review author resolved discrepancies. The unit of analysis was number of participants for the primary analysis and number of scans performed for the secondary analysis. We carried out a meta-analysis to estimate sensitivity and specificity of CDUS or CE-CDUS using a bivariate model. We analysed each index test separately. As potential sources of heterogeneity, we explored year of publication, characteristics of included participants (age and gender), direction of the study (retrospective, prospective), country of origin, number of CDUS operators, and ultrasound manufacturer. Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair (Review)

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Single-centre Prospective Comparison Between Contrast-Enhanced Ultrasound and Computed Tomography Angiography after EVAR

Cited by 75 publications

References 23 publications

Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications

Demystifying Endovascular Treatment of Abdominal Aortic Aneurysms: A Study by CT Angiography at a Tertiary Hospital

Ultrasonography for endoleak detection after endoluminal abdominal aortic aneurysm repair

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