Management of Aortic Sac Enlargement Following Successful EVAR in a Frail Patient

Dellagrammaticas, D.; Hassan, A. Bassim; Mani, Kevin

doi:10.1016/j.ejvs.2015.09.003

Cited by 5 publications

(2 citation statements)

References 29 publications

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“…Imaging techniques applicable to detection of endovascular aneurysm repair complications and used during follow-up. (Modified from Dellagrammaticas et al588 ).…”

mentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Wanhainen¹,

Verzini²,

Herzeele³

et al. 2019

European Journal of Vascular and Endovascular Surgery

1,962

1,522

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“…Imaging techniques applicable to detection of endovascular aneurysm repair complications and used during follow-up. (Modified from Dellagrammaticas et al588 ).…”

mentioning

confidence: 99%

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Wanhainen¹,

Verzini²,

Herzeele³

et al. 2019

European Journal of Vascular and Endovascular Surgery

1,962

1,522

View full text Add to dashboard Cite

“…In practice, invasive catheter angiography is usually performed as part of a reintervention, so we set CTA as the gold standard instead under the assumption that CTA is superior to other modalities except catheter angiography in predicting EVAR complications. 27 However, CTA still misses endoleak or other complications on some occasions, and this should be considered when interpreting the results of this study. Second, it was not confirmed whether a similar result would appear in a later follow-up period because the analysis focused on patients within 60 days after EVAR.…”

Section: Discussionmentioning

confidence: 90%

Contrast enhanced duplex ultrasound for early postoperative follow-up after endovascular aneurysm repair: Relation to patient’s initial risk of complications

et al. 2022

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Objectives Current guidelines recommend initial postoperative follow-up with computed tomography angiography (CTA) after endovascular aneurysm repair (EVAR). However, CTA has risks associated with ionizing radiations and nephrotoxic contrast agents. We investigated possibilities to replace the initial postoperative CTA with contrast enhanced duplex ultrasound (CE-DUS) in selected patients. Methods Out of the 273 consecutive patients who underwent EVAR, 173 were excluded and the 100 patients who underwent CTA and CE-DUS imaging concurrently (≤1 month interval between CTA and CE-DUS imaging) within 60 days after EVAR were analyzed. Patients who underwent EVAR outside the manufacturer’s instructions for use or who had endoleaks discovered on intraoperative angiography were classified as the high-risk group, otherwise, they were classified as the low-risk group. Measurements of diagnostic values of CE-DUS related to the detection of complications were calculated using CTA as the gold standard. McNemar’s test was performed to compare these values and Pearson correlation coefficient was derived to compare CE-DUS measurements of sac diameters with CTA. Results In the low-risk group, no difference was observed between CE-DUS and CTA in the detection of EVAR-related complications (sensitivity = 0.95, specificity = 0.93). In the high-risk group, CE-DUS was not as accurate as CTA for the detection of overall EVAR-related complications (sensitivity = 0.57, specificity = 0.86, p = 0.04) and for the detection of complications other than endoleaks ( p = 0.02). Regarding sac diameter measurement, there was good agreement between CE-DUS and CTA ( r = 0.92, p < 0.001). Conclusions First postoperative CE-DUS was reliable for the evaluation of EVAR-related complications compared to CTA in selected patients. Individualized EVAR follow-up strategy using CE-DUS based on the initial risk of EVAR-related complications should be considered.

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Risk Factors for Early and Late Type Ib Endoleak Following Endovascular Abdominal Aortic Aneurysm Repair

Choi

Lee

et al. 2021

Annals of Vascular Surgery

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Management of Aortic Sac Enlargement Following Successful EVAR in a Frail Patient

Cited by 5 publications

References 29 publications

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Editor's Choice – European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms

Contrast enhanced duplex ultrasound for early postoperative follow-up after endovascular aneurysm repair: Relation to patient’s initial risk of complications

Risk Factors for Early and Late Type Ib Endoleak Following Endovascular Abdominal Aortic Aneurysm Repair

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