Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair
Background: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a c...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2015-01-01
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| Series: | Chinese Medical Journal |
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| Online Access: | http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=18;spage=2491;epage=2497;aulast=Yang |
| _version_ | 1819198530495971328 |
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| author | Xiao Yang Yue-Xin Chen Bo Zhang Yu-Xin Jiang Chang-Wei Liu Rui-Na Zhao Qiong Wu Da-Ming Zhang |
| author_facet | Xiao Yang Yue-Xin Chen Bo Zhang Yu-Xin Jiang Chang-Wei Liu Rui-Na Zhao Qiong Wu Da-Ming Zhang |
| author_sort | Xiao Yang |
| collection | DOAJ |
| description | Background: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a certain percentage of missed diagnosis. Preliminary studies on contrast-enhanced ultrasound (CEUS) have shown that the sensitivity of CEUS for detecting endoleak is no lower than that of CTA. To investigate the advantages of CEUS, we conducted CEUS examinations of post-EVAR cases in which CTA failed to detect endoleak or could not verify the type of endoleak.
Methods: Post-EVAR patients, who were clinically considered to have endoleak and met the inclusion criteria were enrolled between March 2013 and November 2014. All of the patients underwent color Doppler flow imaging (CDFI) and a CEUS examination. Size, location, microbubble dispersion, and hemodynamic characteristics of leaks were recorded. Comparison between the diagnosis of CEUS and CDFI was conducted using Fisher′s exact test and clinical outcomes of all patients were followed up.
Results: Sixteen patients were enrolled, and 12 (75%) had endoleaks with verified types by CEUS. Among 12 cases of endoleaks were positive by CEUS, 10 were CDFI-positive, and the four CEUS-negative cases were all negative by CDFI. The diagnostic values of CEUS and CDFI were statistically different (P = 0.008). Six patients with high-pressure endoleaks received endovascular re-intervention guided by CEUS results. One patient with type III endoleak had open surgery when endovascular repair failed.
Conclusions: CEUS is a new, safe, and effective means for detection of endoleaks post-EVAR. This technique can be used as a supplement for routine CTA follow-up to provide more detailed information on endoleak and its category. |
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| id | doaj.art-5bfc6e47b0624a8782d5da673e0afae0 |
| institution | Directory Open Access Journal |
| issn | 0366-6999 |
| language | English |
| last_indexed | 2024-12-23T03:01:54Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer |
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| series | Chinese Medical Journal |
| spelling | doaj.art-5bfc6e47b0624a8782d5da673e0afae02022-12-21T18:02:24ZengWolters KluwerChinese Medical Journal0366-69992015-01-01128182491249710.4103/0366-6999.164935Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm RepairXiao YangYue-Xin ChenBo ZhangYu-Xin JiangChang-Wei LiuRui-Na ZhaoQiong WuDa-Ming ZhangBackground: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a certain percentage of missed diagnosis. Preliminary studies on contrast-enhanced ultrasound (CEUS) have shown that the sensitivity of CEUS for detecting endoleak is no lower than that of CTA. To investigate the advantages of CEUS, we conducted CEUS examinations of post-EVAR cases in which CTA failed to detect endoleak or could not verify the type of endoleak. Methods: Post-EVAR patients, who were clinically considered to have endoleak and met the inclusion criteria were enrolled between March 2013 and November 2014. All of the patients underwent color Doppler flow imaging (CDFI) and a CEUS examination. Size, location, microbubble dispersion, and hemodynamic characteristics of leaks were recorded. Comparison between the diagnosis of CEUS and CDFI was conducted using Fisher′s exact test and clinical outcomes of all patients were followed up. Results: Sixteen patients were enrolled, and 12 (75%) had endoleaks with verified types by CEUS. Among 12 cases of endoleaks were positive by CEUS, 10 were CDFI-positive, and the four CEUS-negative cases were all negative by CDFI. The diagnostic values of CEUS and CDFI were statistically different (P = 0.008). Six patients with high-pressure endoleaks received endovascular re-intervention guided by CEUS results. One patient with type III endoleak had open surgery when endovascular repair failed. Conclusions: CEUS is a new, safe, and effective means for detection of endoleaks post-EVAR. This technique can be used as a supplement for routine CTA follow-up to provide more detailed information on endoleak and its category.http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=18;spage=2491;epage=2497;aulast=YangAbdominal Aortic Aneurysm; Color Doppler Flow Imaging; Contrast-enhanced Ultrasound; Endoleak; Endovascular Aneurysm Repair |
| spellingShingle | Xiao Yang Yue-Xin Chen Bo Zhang Yu-Xin Jiang Chang-Wei Liu Rui-Na Zhao Qiong Wu Da-Ming Zhang Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair Chinese Medical Journal Abdominal Aortic Aneurysm; Color Doppler Flow Imaging; Contrast-enhanced Ultrasound; Endoleak; Endovascular Aneurysm Repair |
| title | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
| title_full | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
| title_fullStr | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
| title_full_unstemmed | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
| title_short | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
| title_sort | contrast enhanced ultrasound in detecting endoleaks with failed computed tomography angiography diagnosis after endovascular abdominal aortic aneurysm repair |
| topic | Abdominal Aortic Aneurysm; Color Doppler Flow Imaging; Contrast-enhanced Ultrasound; Endoleak; Endovascular Aneurysm Repair |
| url | http://www.cmj.org/article.asp?issn=0366-6999;year=2015;volume=128;issue=18;spage=2491;epage=2497;aulast=Yang |
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