Heterogeneity in Surveillance after Endovascular Aneurysm Repair in the UK

Karthikesalingam, Alan; Pagé, A; Pettengell, Christopher; Hinchliffe, Robert J.; Loftus, Ian; Thompson, Matt; Holt, Peter

doi:10.1016/j.ejvs.2011.06.053

Cited by 56 publications

(46 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concerns with current practice include the diagnostic accuracy of different imaging modalities, patient attendance rates, interval presentations leading to reintervention, and nephrotoxicity and radiation exposure from CT. This uncertainty is reflected by wide variations in surveillance protocols used at different centres.…”

Section: Discussionmentioning

confidence: 99%

International validation of a risk score for complications and reinterventions after endovascular aneurysm repair

Karthikesalingam¹,

Vidal‐Diez²,

Bruin³

et al. 2015

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

International validation of a risk score for complications and reinterventions after endovascular aneurysm repair

Karthikesalingam¹,

Vidal‐Diez²,

Bruin³

et al. 2015

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…This study reflects long-term outcome at a single institution and may not be applicable to lower-volume endovascular practice 39 . Surveillance after EVAR remains heterogeneous 40 with the potential to confound comparisons of late endograft complications. As EVAR can be done with low mid-term aneurysm-related mortality, the improved prediction and detection of endograft complications, including sac expansion, should be the focus of further research.…”

Section: Discussionmentioning

confidence: 99%

Aortic rupture and sac expansion after endovascular repair of abdominal aortic aneurysm

Holt

Karthikesalingam

Patterson

et al. 2012

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…23 This audit and previous research has shown heterogeneity in the incidence, detection rate and classification of the type of endoleak, 30 which may be due to differences in postoperative EVAR surveillance timing, the modality used, the technical capabilities of the chosen modality and the level of training and experience of the reporting practitioner. 3,30,31 In the context of hospital-based detection of abdominal aortic aneurysms (AAA) and the implementation of national AAA screening programmes, 32,33 the differences in postoperative EVAR surveillance practice may have international implications. It may lead to differences in cost-effectiveness, patient satisfaction and overall outcomes after EVAR.…”

Section: Detection and Classification Of The Type Of Endoleaksmentioning

confidence: 99%

Surveillance of Endovascular Aneurysm Repair: An Audit of Sonographer-Led Ultrasound and Radiologist-Led Computed Tomography Services

2013

View full text Add to dashboard Cite

Objectives: Postoperative complications associated with endovascular aneurysm repair (EVAR) mandate the need for lifelong surveillance. The aim of this audit was to compare the detection rates of endoleaks during the first 10 months of a combined sonographer-led colour Doppler ultrasound (CDUS) and radiologist-led contrast-enhanced computed tomography (CECT), postoperative EVAR surveillance programme, within a single National Health Service Hospital. Methods: A prospective audit was carried out of all patients with EVAR, who had same-day CECT and CDUS surveillance examinations between March 2010 and January 2011. CECT examinations were reported by three consultant vascular radiologists. Of 66 CDUS examinations, 64 (97%) were performed and reported by four certified vascular sonographers. The reports of dual-modality, same-day scans were compared, to establish agreement on the presence and classification of the type, or absence of endoleaks. CECT was used as the gold standard, against which the sensitivity and specificity of CDUS in endoleak detection was determined.Results: Sixty-six paired same-day CECT and CDUS reports were compared. Ten endoleaks were identified by CECT (15% incidence) and eight (80%) of 10 were type II. The number of observed agreements was 58 (88%) of 66; CDUS missed six endoleaks (five type II) and suggested two false-positives. CDUS had a sensitivity of 40% and a specificity of 96%. Conclusions: In our study, CDUS demonstrated an excellent specificity but had a low sensitivity for endoleak detection. We agree CDUS cannot effectively replace CECT as the sole imaging modality. Research to determine an international consensus for an effective and efficient postoperative EVAR surveillance patient pathway is required.

show abstract

Heterogeneity in Surveillance after Endovascular Aneurysm Repair in the UK

Abstract: Significant heterogeneity exists in surveillance after EVAR in the UK. Efforts should be made to establish consensus towards a national surveillance protocol.

Cited by 56 publications

References 30 publications

International validation of a risk score for complications and reinterventions after endovascular aneurysm repair

International validation of a risk score for complications and reinterventions after endovascular aneurysm repair

Aortic rupture and sac expansion after endovascular repair of abdominal aortic aneurysm

Surveillance of Endovascular Aneurysm Repair: An Audit of Sonographer-Led Ultrasound and Radiologist-Led Computed Tomography Services

Contact Info

Product

Resources

About