Non-contrast MR imaging for detecting endoleak after abdominal endovascular aortic repair

Resta, Elda Chiara; Secchi, Francesco; Giardino, Antonello; Nardella, Veronica G.; Leo, Giovanni Di; Flor, Nicola; Sardanelli, Francesco

doi:10.1007/s10554-012-0060-2

Cited by 14 publications

(11 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…When TOF-MRA imaging is used alone in patients with a low estimated glomerular filtration rate (eGFR), its sensitivity for endoleak detection can be as low as 54% (44). However, when TOF is used in conjunction with gadolinium-enhanced MRA, it has 97% concordance with angiography for the detection of endoleaks (45).…”

Section: Mramentioning

confidence: 99%

Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management

Daye

Walker

2018

Cardiovasc. Diagn. Ther.

179

139

View full text Add to dashboard Cite

In recent decades, endovascular aneurysm repair or endovascular aortic repair (EVAR) has become an acceptable alternative to open surgery for the treatment of thoracic and abdominal aortic aneurysms and other aortic pathologies such as the acute aortic syndromes (e.g., penetrating aortic ulcer, intramural hematoma, dissection). Available data suggest that endovascular repair is associated with lower perioperative 30-day all-cause mortality as well as a significant reduction in perioperative morbidity when compared to open surgery. Additionally, EVAR leads to decreased blood loss, eliminates the need for cross-clamping the aorta and has shorter recovery periods than traditional surgery. It is currently the preferred mode of treatment of thoracic and abdominal aortic aneurysms in a subset of patients who meet certain anatomic criteria conducive to endovascular repair. The main disadvantage of EVAR procedures is the high rate of post-procedural complications that often require secondary re-intervention. As a result, most authorities recommend lifelong imaging surveillance following repair. Available surveillance modalities include conventional radiography, computed tomography, magnetic resonance angiography, ultrasonography, nuclear imaging and conventional angiography, with computed tomography currently considered to be the gold standard for surveillance by most experts. Following endovascular abdominal aortic aneurysm (AAA) repair, the rate of complications is estimated to range between 16% and 30%. The complication rate is higher following thoracic EVAR (TEVAR) and is estimated to be as high as 38%. Common complications include both those related to the endograft device and systemic complications. Device-related complications include endoleaks, endograft migration or collapse, kinking and/or stenosis of an endograft limb and graft infection. Post-procedural systemic complications include end-organ ischemia, cerebrovascular and cardiovascular events and post-implantation syndrome. Secondary re-interventions are required in approximately 19% to 24% of cases following endovascular abdominal and thoracic aortic aneurysm repair respectively. Typically, most secondary reinterventions involve the use of percutaneous techniques such as placement of cuff extension devices, additional endograft components or stents, enhancement of endograft fixation, treatment of certain endoleaks using various embolization techniques and embolic agents and thrombolysis of occluded endograft components. Less commonly, surgical conversion and/or open surgical modification are required. In this article, we provide an overview of the most common complications that may occur following endovascular repair of thoracic and AAAs. We also summarize the current surveillance recommendations for detecting and evaluating these complications and discuss various current secondary re-intervention approaches that may typically be employed for treatment.

show abstract

Section: Mramentioning

confidence: 99%

Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management

Daye

Walker

2018

Cardiovasc. Diagn. Ther.

179

139

View full text Add to dashboard Cite

show abstract

“…The age of any thrombus within the sac can be evaluated based on the inherent signal characteristics of the thrombus composition. A recent study has shown that non-contrast MRA has high sensitivity for endoleak detection with a high negative predictive value using steady state free precession sequences [38]. MRA has also been shown to be at least as sensitive as CTA in the overall detection of endoleaks and is thought to be more sensitive than CTA in detecting Type II endoleaks [39,40].…”

Section: Magnetic Resonance Angiographymentioning

confidence: 99%

Radiological Evaluation of Abdominal Endovascular Aortic Aneurysm Repair

et al. 2015

View full text Add to dashboard Cite

Endovascular aortic aneurysm repair (EVAR) is an alternative to open surgical repair of aortic aneurysms offering lower perioperative mortality and morbidity. As experience increases, clinicians are undertaking complex repairs with hostile aortic anatomy using branched or fenestrated devices or extra components such as chimneys to ensure perfusion to visceral branch vessels whilst excluding the aneurysm. Defining the success of EVAR depends on both clinical and radiographic criteria, but ultimately depends on complete exclusion of the aneurysm from the circulation. Aortic stent grafts are monitored using a combination of imaging modalities including computed tomography angiography (CTA), ultrasonography, magnetic resonance imaging, plain films, and nuclear medicine studies. This article describes when and how to evaluate aortic stent grafts using each of these modalities along with the characteristic features of several of the main stent grafts currently used in clinical practice. The commonly encountered complications from EVAR are also discussed and how they can be detected using each imaging modality. As the radiation burden from serial follow up CTA imaging is now becoming a concern, different follow-up imaging strategies are proposed depending on the complexity of the repair and based on the relative merits and disadvantages of each imaging modality.

show abstract

“…Resta et al [22] first reported the potential of unenhanced MR imaging for detecting endoleaks in their retrospective study of 23 patients. They used a true fast imaging with steady-state precession (FISP) sequence, which is a similar pulse sequence to ordinary BTFE.…”

Section: Discussionmentioning

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

View full text Add to dashboard Cite

• 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.

show abstract

Non-contrast MR imaging for detecting endoleak after abdominal endovascular aortic repair

Cited by 14 publications

References 17 publications

Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management

Complications of endovascular aneurysm repair of the thoracic and abdominal aorta: evaluation and management

Radiological Evaluation of Abdominal Endovascular Aortic Aneurysm Repair

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

Contact Info

Product

Resources

About