Use of Contrast-enhanced Ultrasound in Follow-Up after Endovascular Aortic Aneurysm Repair

McWilliams, Richard G.; Martin, Janis; White, Donagh; Gould, Debby; Harris, Peter L.; Fear, Simon; Brennan, John A.; Gilling-Smith, Geoffrey L.; Bakran, Ali; Rowlands, P. C.

doi:10.1016/s1051-0443(99)70199-5

Cited by 75 publications

(42 citation statements)

References 7 publications

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“…eral modalities are used, including computed tomographic angiography (CTA), magnetic resonance angiography (MRA), or ultrasound examination. [1][2][3][4][5][6][7] CTA is the most widely employed imaging modality but has the drawback of iodinated contrast. Many patients have contrast allergies or renal insufficiency that prevents the use of contrast agents.…”

Section: Fig 1ࡗthementioning

confidence: 99%

Durability and Validity of a Remote, Miniaturized Pressure Sensor in an Animal Model of Abdominal Aortic Aneurysm

Milner¹,

Ruurda²,

Blankensteijn³

2004

Journal of Endovascular Therapy

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ࡗ ࡗPurpose: To investigate whether a remote, miniaturized pressure sensor could maintain calibration and function through organized thrombus over an extended period in a porcine model of abdominal aortic aneurysm (AAA). Methods: Six adult pigs had an AAA surgically created and excluded. A sensor zeroed to atmospheric pressure was placed within the aneurysm sac and another within the suprarenal aorta of each animal. Pressure measurements were taken at the initial operation and then on a weekly basis over 2 months. The aortic sensors were correlated to an intraarterial pressure catheter at the initial operation and at the time of sacrifice. Back-table sensor correlation with atmospheric pressure was done at the time of explantation. Results: Three animals died during the follow-up period. Five animals were available for 6-week follow-up, of which 3 survived for the complete 8-week protocol. Two of the surviving animals had an intra-aortic sensor. All 5 aneurysm sac sensors functioned throughout the experimental period. At the time of sacrifice, the sacs contained a large amount of organized thrombus in which the sac sensors were deeply embedded. The 3 aortic sensors also functioned throughout the course of the experiments. The pressures correlated within 5 mmHg to the catheter-based measurements taken at the initial operation and at the time of sacrifice. Comparison to atmospheric pressure revealed no calibration offset in any sensor.Conclusions: This chronic implantation study demonstrates the durability of a remote, miniaturized pressure sensor within a surgically created aneurysm sac as well as the suprarenal aorta of a porcine AAA model. There was no calibration offset in any of the sensors, and they remained valid at explantation. We believe that this is further evidence of the potential applicability of this sensor for clinical use. The current gold standard for evaluating the status of an excluded abdominal aortic aneurysm (AAA) after endovascular aneurysm repair (EVAR) is interval imaging studies. Sev-

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Section: Fig 1ࡗthementioning

confidence: 99%

Durability and Validity of a Remote, Miniaturized Pressure Sensor in an Animal Model of Abdominal Aortic Aneurysm

Milner¹,

Ruurda²,

Blankensteijn³

2004

Journal of Endovascular Therapy

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“…Currently, single or multiple-row spiral computed tomographic angiography (CTA), intraarterial digital subtraction angiography (DSA), and/or duplex sonography are used to exclude early and late complications associated with the stent-graft device and to assess aneurysm sac diameter changes. Computed tomographic angiography has been recommended as the modality of choice [1,2,3,4,5,6] and is the required method for the EUROSTAR registry [6]. The disadvantages of CTA are its contrast-medium-associated nephrotoxicity and its potential for anaphylactic reactions caused by iodinated contrast medium.…”

Section: Introductionmentioning

confidence: 99%

MR angiography vs CT angiography in the follow-up of nitinol stent grafts in endoluminally treated aortic aneurysms

et al. 2002

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Our objective was to evaluate the accuracy of contrast-enhanced 3D MR angiography (MRA) in the follow-up of patients with endoluminally treated aortic aneurysms and correlate these findings with uni- or biphasic CT angiography (CTA). Forty MR angiograms in 32 patients with implanted aortic nitinol stent grafts were compared to CTA. Twenty-two MR examinations were correlated with arterial-phase CTA (uniphasic), and 18 MR examinations were correlated with biphasic CTA. Uniphasic CTA demonstrated three type-1/type-3 endoleaks and four reperfusion (type-2) endoleaks. In addition, MRA depicted two type-2 reperfusion endoleaks that were missed by CTA. Using biphasic CTA, two type-1/type-3 endoleaks and three reperfusion (type-2) endoleaks were detected; of those, delayed scanning detected three reperfusion (type-2) endoleaks missed during arterial-phase CTA. In addition to the findings by CTA, MRA depicted another type-2 reperfusion endoleak. Magnetic resonance angiography is at least as sensitive as uni- or biphasic CTA for detecting endoleaks and may consequently offer advantages in patients with contraindications to iodinated contrast agents.

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“…The leak is located both anterior (straight arrow) and posterior (curved arrow) to the graft with parietal and stent-graft contact. b Gadolinium-enhanced MRA at the same level shows the anterior (curved arrow) and posterior leak (straight arrow) intravenous ultrasound agent is reported in a small series to increase the sensitivity of CDUS for detection of leak to a level comparable to that of CT [27]. In 6 patients enhanced CDUS showed a leak not visible with CT.…”

Section: Jafar Golzarian Julien Struyvenmentioning

confidence: 91%

Imaging of complications after endoluminal treatment of abdominal aortic aneurysms

Golzarian

Struyven

2001

Eur Radiol

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Endovascular repair of abdominal aortic aneurysm is becoming a valuable alternative to open surgery in selected patients. With the recognition of this new treatment, however, many complications, some of them life-threatening, are reported. Imaging plays a major role in the detection of these complications. This article reviews the role of imaging techniques in the detection of these complications.

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Use of Contrast-enhanced Ultrasound in Follow-Up after Endovascular Aortic Aneurysm Repair

Cited by 75 publications

References 7 publications

Durability and Validity of a Remote, Miniaturized Pressure Sensor in an Animal Model of Abdominal Aortic Aneurysm

Durability and Validity of a Remote, Miniaturized Pressure Sensor in an Animal Model of Abdominal Aortic Aneurysm

MR angiography vs CT angiography in the follow-up of nitinol stent grafts in endoluminally treated aortic aneurysms

Imaging of complications after endoluminal treatment of abdominal aortic aneurysms

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