Tailored CT angiography in follow-up after endovascular aneurysm repair (EVAR): combined dose reduction techniques

Böning, Georg; Rotzinger, Roman; Kahn, Johannes; Freyhardt, Patrick; Renz, Diane M.; Maurer, Martin; Streitparth, Florian

doi:10.1177/0284185118756952

Cited by 14 publications

(10 citation statements)

References 26 publications

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“…A split bolus technique which divides the contrast bolus to perform a single-phase acquisition during a mixed early and delayed phase could further reduce the radiation dose by omitting multiple-phase scanning. 15 Dual-energy CT is another approach to reduce the amount of contrast medium, while maintaining the image quality. 4,16 As much as 70% reduction in iodine dose with a total amount of 15 g iodine could be achieved using dual-energy CT. 4 One major strength of this technique is that the appropriate monochromatic image could be reconstructed out of multiple energy levels.…”

Section: Discussionmentioning

confidence: 99%

Double region of interest timing bolus technique following endovascular aortic repair: Short-term prognosis analysis

et al. 2019

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Objectives To compare the incidence rate of reintervention in patients with and without complication findings at aortic computed tomography using double region of interest timing bolus (DRTB) method after endovascular stent placement of the aorta. Methods We included 40 patients who underwent computed tomography of the aorta using DRTB method after endovascular stent placement. DRTB method allows to scan the aorta with a short injection time of 9 s by synchronizing the scan speed to the aortic flow. Complication findings at computed tomography were defined as endoleak, rupture, occlusion, and infection. The primary endpoint was reintervention, which was defined as any of the following three events: conversion to open repair, graft revision, or secondary intervention. Results The mean contrast medium during computed tomography angiography was 38.6 ± 3.9 mL. Complication findings at computed tomography were present in 10 patients (25%): endoleak ( n = 9) and infection ( n = 1). During a median follow-up of 7 months (interquartile range, 4–11 months), two patients experienced reintervention. Kaplan–Meier curves by complication findings showed that event rate at 6 months was significantly higher in patients with complication findings than in patients without (20% vs 0%, p = 0.01). No patients without complication findings at computed tomography experienced reintervention. Conclusions No complication findings at computed tomography after intervention of the aorta resulted in good prognosis in patients who underwent aortic computed tomography using DRTB method.

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Section: Discussionmentioning

confidence: 99%

Double region of interest timing bolus technique following endovascular aortic repair: Short-term prognosis analysis

et al. 2019

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“…A drawback is increased image noise that degrades overall image readability. A solution would be applying iterative or model-based image reconstructions [48]. These techniques use multiple advanced mathematical operations to optimize the image by reducing the noise.…”

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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“…A disadvantage is the increased image noise, which reduces image readability. Thus, low kVp scanning requires the use of iterative or model-based image reconstructions [35]. These techniques use multiple advanced mathematical operations to optimise the image by reducing the noise.…”

Section: Follow-up Methodsmentioning

confidence: 99%

Contemporary follow-up imaging after endovascular repair of lower extremity atherosclerotic lesions

Michalska¹,

Kazimierczak²,

Leszczyński³

et al. 2018

Pol J Radiol

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Atherosclerotic disease is currently one of the most important problems of modern medicine because it is a leading cause of increased morbidity, morbidity and mortality, and disability in the Western World. Atherosclerosis of the lower limbs (peripheral arterial disease – PAD) significantly affects the quality of life and in a considerable proportion of patients is a cause of disability. Radical treatment of PAD, both surgical and endovascular, aims at revascularisation of ischaemic tissues distal to obstructed arteries. Surveillance imaging is an important part of patient management after endovascular repair of PAD. Apart from availability and contraindications, challenges of imaging include calcifications, flow dynamics, and stent-related artefacts. The aim of this paper was to review the current literature on imaging methods for follow-up after endovascular repair of atherosclerotic lesions, with special attention paid to novel techniques. As a non-invasive modality, ultrasound is still the first-line examination, but computed tomography angiography remains a current state-of-the art technique for follow-up. However, since current imaging recommendations seem not to adhere to contemporary imaging possibilities, more attention should be paid to recent improvements in magnetic resonance angiography technology.

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Tailored CT angiography in follow-up after endovascular aneurysm repair (EVAR): combined dose reduction techniques

Cited by 14 publications

References 26 publications

Double region of interest timing bolus technique following endovascular aortic repair: Short-term prognosis analysis

Double region of interest timing bolus technique following endovascular aortic repair: Short-term prognosis analysis

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

Contemporary follow-up imaging after endovascular repair of lower extremity atherosclerotic lesions

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