Is CT still a method of monitoring patients after endovascular treatment of abdominal aortic aneurysms?
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 2
Abstract
Introduction. The endovascular treatment of patient with abdominal aorta aneurysms has been a recognized alternative to classic surgery. One of the most common complications is an endoleak developing due to incomplete exclusion of the aneurysmal sac from circulation.Aim. To assess the value of ultrasound contrast agents for the diagnosis of endoleaks in patients with AAA treated by stent graft implantation.Material and methods. One hundred and ninety-eight patients with AAA were treated with stent graft implantation. Follow-up examinations, i.e. pre- and post-contrast ultrasound and angio-CT, were performed 6 months after treatment in all patients. In each ultrasound examination, colour, power, Bflow options were used before and after contrast injection; additionally, contrast-enhanced ultrasound (CEUS) was performed after contrast administration.Results. During the follow-up examinations after 6 months, pre-contrast ultrasound performed in all options (colour, power, Bflow) revealed 16 endoleaks: 6 type IA, 4 type IB, type 2 IIA and 4 type IIB; in post-contrast ultrasound using CEUS 22 endoleaks were confirmed and additionally 4 endoleaks were diagnosed: 2 type IIA, and 2 type IIB. In angio-CT, 22 endoleaks were diagnosed: 1 type IA, 5 type IB, 4 type IIA, and 7 type IIB. None of the four additional endoleaks observed with CEUS was found in angio-CT.Conclusions. The use of ultrasound contrast media significantly increases the sensitivity of ultrasound in the diagnosis of endoleaks, particularly type II ones.CEUS examinations show the greatest sensitivity in detecting endoleaks, as they disclose the endoleaks unrecognized by other techniques, including angio-CT.Post-contrast ultrasound can replace angio-CT in monitoring patients after stent graft implantations.
Authors and Affiliations
Anna Drelich-Zbroja, Tomasz Jargiełło, Elżbieta Czekajska-Chehab, Monika Miazga, Michał Sojka, Krzysztof Pyra, Klaudia Karska, Małgorzata Szczerbo-Trojanowska
Keywords
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