Detection of Endoleaks after Endovascular Repair of Abdominal Aortic Aneurysm: Value of Unenhanced and Delayed Helical CT Acquisitions

Rozenblit, Alla M.; Patlas, Michael N.; Rosenbaum, Ayala T.; Okhi, Takao; Veith, Frank J.; Laks, Mitchell P.; Ricci, Zina J.

doi:10.1148/radiol.2272020555

Cited by 158 publications

(70 citation statements)

References 27 publications

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“…Unenhanced, arterial and venous phase acquisitions have been utilized for optimization of the detection of possible complications including endoleaks [29]. The possibility to eliminate the arterial phase without loss of diagnostic information with a dose savings of up to 36.5% of the total radiation has been shown to be feasible [30].…”

Section: Dual Energy Ct After Abdominal Aortic Aneurysm Repairmentioning

confidence: 99%

Dual energy CT: preliminary observations and potential clinical applications in the abdomen

et al. 2008

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Dual energy CT (DECT) is a new technique that allows differentiation of materials and tissues based on CT density values derived from two synchronous CT acquisitions at different tube potentials. With the introduction of a new dual source CT system, this technique can now be used routinely in abdominal imaging. Potential clinical applications include evaluation of renal masses, liver lesions, urinary calculi, small bowel, pancreas, and adrenal glands. In CT angiography of abdominal aortic aneurysms, dual energy CT techniques can be used to remove bones from the datasets, and virtual unenhanced images allow differentiation of contrast agent from calcifying thrombus in patients with endovascular stents. This review describes potential applications, practical guidelines, and limitations of dual energy CT in the abdomen.

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Section: Dual Energy Ct After Abdominal Aortic Aneurysm Repairmentioning

confidence: 99%

Dual energy CT: preliminary observations and potential clinical applications in the abdomen

et al. 2008

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“…The MDCTA dataset, in combination with a variety of 2D and 3D postprocessing options, allows an accurate qualitative and quantitative assessment of the vascular structures. Therefore, MDCTA is nowadays well accepted for pre-and postprocedural aortic aneurysm imaging [16,17].…”

Section: Imaging Techniquementioning

confidence: 99%

“…The control examination after intervention should include an unenhanced acquisition and two contrast-enhanced CT data sets (arterial and delayed phase). Some authors recommend delayed phase imaging because endoleaks show variable flow rates and are, therefore, not necessarily detected during the early contrast-enhanced phase [16,20].…”

Section: Imaging Techniquementioning

confidence: 99%

Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know

et al. 2009

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Purpose: Endovascular aneurysm repair of the infrarenal or thoracic aorta has been shown to be a less invasive alternative to open surgery. A combined aneurysm of the thoracic and abdominal aorta is complex and challenging; the involvement of renal and/or visceral branches requires new treatment methods. Methods: A hybrid approach is currently an accepted alternative to conventional surgery. Renal and/or visceral revascularisation enables subsequent stent-graft placement into the visceral portion of the aorta. Results: Knowledge of the surgical procedure and a precise assessment of the vascular morphology are crucial for pre-procedural planning and for detection of post-procedural complications. Multi-detector computed tomography angiography (MDCTA) combined with two-and threedimensional (2D and 3D) rendering is useful for pre-interventional planning and for the detection of postprocedural complications. Threedimensional rendering allows proper anatomical analyses, influencing interventional strategies and resulting in a better outcome. Conclusions: With the knowledge of procedurespecific MDCTA findings in various vascular conditions, the radiologist and surgeon are able to perform an efficient pre-interventional planning and follow-up examination. Based on our experience with this novel technique of combined open and endovascular aortic aneurysm treatment, this pictorial review illustrates procedure-specific imaging findings, including common and rare complications, with respect to 2D and 3D post-processing techniques.

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“…Although EVAR shows a perioperative survival advantage (within 30 days after surgery) over open surgery, this advantage is gradually diminished over time, owing to the risk of late aneurysm rupture [2,3]. To prevent this sequela, contrast-enhanced computed tomography (CT) is widely used to detect and observe endoleaks, as well as to observe any changes of the aneurysmal diameters [4,5]. Endoleaks at graft ends (type I) and those through the fabric tears or the unsealed junctions of device components (type III) should be treated immediately upon detection, while endoleaks due to retrograde flow of branch vessels (type II) should be carefully observed and treated when they are persistent and accompanied with aneurysm sac expansion > 5 mm [6].…”

Section: Introductionmentioning

confidence: 99%

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT

et al. 2016

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• Flow suppression significantly reduces endoleak signals on MSDE-prepared BTFE images. • Subtraction images of MSDE-prepared BTFE sequences ± flow suppression demonstrate endoleaks. • MSDE-prepared BTFE sequences indicate high diagnostic values (>90 %) except PPV (77 %). • MSDE-prepared BTFE sequences need further refinement to reduce false positives. • Endoleaks can be detected without contrast injection using MSDE-prepared BTFE sequences.

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Detection of Endoleaks after Endovascular Repair of Abdominal Aortic Aneurysm: Value of Unenhanced and Delayed Helical CT Acquisitions

Abstract: A delayed CT acquisition enables detection of additional endoleaks, while an unenhanced acquisition helps eliminate indeterminate results. Thus, both acquisitions contribute to accurate diagnosis of endoleaks when combined with an arterial phase acquisition.

Cited by 158 publications

References 27 publications

Dual energy CT: preliminary observations and potential clinical applications in the abdomen

Dual energy CT: preliminary observations and potential clinical applications in the abdomen

Hybrid-repair of thoraco-abdominal or juxtarenal aortic aneurysm: what the radiologist should know

Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: Feasibility study in comparison with contrast-enhanced CT

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