Radiological Evaluation of Abdominal Endovascular Aortic Aneurysm Repair

Abstract

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.

Endovascular treatment of infrarenal aortic aneurysm using the ANKURA stent graft – one-center case series

“…The results of this case series seem to confirm the safety and efficacy of elective ANKURA stent graft placement for AAA. Early and mid-term complication rates are comparable to those of other stent grafts with suprarenal fixation; the proportions of endoleaks and repeat interventions were 11.4% and 7.6%, respectively, which is consistent with literature data on elective EVARs [5][6][7][8][9][10]. No deaths related to the device or the EVAR procedure were noted.…”

Cross-sectional imaging of aortic infections

“…The acquisition of a delayed post-contrast CT (approximately 70 s) can help to demonstrate a fistula, if present. Pseudoaneurysm formation is a serious complication of graft infection, occurring particularly in cases of endovascular graft infection [88, 89].

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