Endoleaks after endovascular repair of abdominal aortic aneurysm: value of CEUS

Endovascular repair (EVAR) is playing an increasingly role in the treatment of abdominal aortic aneurysm. A successful procedure depends on the complete sealing of the aneurysm sac from blood flow to achieve general pressure relief and avoid aneurysm rupture, with a shrinkage of the aneurysm sac. Th...

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Bibliographic Details
Published in:Abdominal imaging 2010-02, Vol.35 (1), p.106-114
Main Authors: Iezzi, R., Cotroneo, A. R., Basilico, R., Simeone, A., Storto, M. L., Bonomo, L.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - diagnostic imaging
Aortic Aneurysm, Abdominal - surgery
Biological and medical sciences
Blood and lymphatic vessels
Blood Vessel Prosthesis Implantation
Cardiology. Vascular system
Contrast Media
Diseases of the aorta
Female
Gastroenterology
Gastroenterology. Liver. Pancreas. Abdomen
Hepatology
Humans
Imaging
Male
Medical sciences
Medicine
Medicine & Public Health
Phospholipids
Postoperative Complications - diagnostic imaging
Radiology
Stents
Sulfur Hexafluoride
Ultrasonography
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Summary:Endovascular repair (EVAR) is playing an increasingly role in the treatment of abdominal aortic aneurysm. A successful procedure depends on the complete sealing of the aneurysm sac from blood flow to achieve general pressure relief and avoid aneurysm rupture, with a shrinkage of the aneurysm sac. The most common complication of EVAR is endoleak that is the persistence of perigraft flow within the aneurysm sac, which has to be considered the major cause of enlargement and rupture of the aneurysm, and the main indication for surgical late conversion. For this reason, strict surveillance of these patients is mandatory for the early detection of endoleaks and the preferred method of follow-up is represented by CT angiography. However, CTA has limitations. The investigation is repeated several times, making radiation exposure a necessary concern. Therefore, it would be useful to have another reliable diagnostic examination during follow-up. Color duplex ultrasound is non-invasive, does not use radiation or contrast medium, is less expensive, easy to perform and widely available. However, this technique obtained poor results in terms of sensitivity in the detection of endoleaks. In the last years, the introduction of ultrasound contrast agents and contrast-specific imaging has, however, rekindled interest in this modality and its potential for replacing of CTA in routine surveillance. The purpose of this review is to highlight the diagnostic value of CEUS in the post-EVAR endoleaks detection.
ISSN:0942-8925
2366-004X
1432-0509
2366-0058
DOI:10.1007/s00261-009-9526-7