Surveillance after Endovascular Aneurysm Repair: Diagnostics, Complications, and Associated Costs

Improved results using Onyx glue for the treatment of persistent type 2 endoleak after endovascular aneurysm repair

“…2,16 However, only the OVER trial found that this early benefit in overall mortality extended beyond 2 years postoperatively. 3 Long-term costs of EVAR related to obligatory surveillance can be significant 17 and are only exacerbated by the costs of secondary interventions. 18 The need for secondary intervention after EVAR ranges from 11% to 19% and is accounted for by the presence of type 2 endoleaks in up to 40% of these cases.…”

Duplex ultrasound as the sole long-term surveillance method post-endovascular aneurysm repair: A safe alternative for stable aneurysms

“…Finally, the high costs of CT follow-up contribute a substantially to the financial disadvantage of EVAR compared with open repair. 4 CDU is an attractive alternative imaging technique. It is less invasive, rapidly available, less expensive, and does not require repeated exposure to radiation or to contrast agents.…”

“…The ideal surveillance modality should be noninvasive, cheap, and reproducible, with high sensitivity and specificity for the detection of endograft related adverse events. Computed tomography with intravenous contrast injection (CT) is currently the standard for long-term EVAR surveillance, but is associated with increased cost 4 and radiation exposure. 5 It could also contribute to the decline in renal function seen after EVAR as a result of contrast nephropathy.…”

Contrast-enhanced Ultrasound versus Computed Tomographic Angiography for Surveillance of Endovascular Abdominal Aortic Aneurysm Repair

“…Among various imaging modalities, computed tomographic (CT) angiography is the most widely used technique for post-EVAR surveillance (5). However, repetitive CT angiography has several important drawbacks, including cumulative radiation dose, nephrotoxic contrast agent load, and high cost (6).…”