Surveillance Imaging following Endovascular Aneurysm Repair: State of the Art

Abstract

Endovascular aneurysmal repair (EVAR) has become a prominent modality for the treatment of abdominal aortic aneurysm. Surveillance imaging is important for the detection of device-related complications, which include endoleak, structural abnormalities, and infection. Currently used modalities include ultrasound, X-ray, computed tomography, magnetic resonance imaging, and angiography. Understanding the advantages and drawbacks of each modality, as well available guidelines, can guide selection of the appropriate technique for individual patients. We review complications following EVAR and advances in surveillance imaging modalities.

AAA Revisited: A Comprehensive Review of Risk Factors, Management, and Hallmarks of Pathogenesis

“…The choice of surgical technique depends on the aneurysm’s morphology and on patient characteristics, such as comorbidities and functional capacity [ 283 , 284 ]. Another consideration is the patient’s ability and willingness to adhere to necessary follow-up surveillance [ 285 , 286 ], as EVAR requires life-long surveillance with regular imaging, owing to the risk of late-onset endoleak, stent graft migration, or infection [ 287 ].…”

Utility of 4D CT in endoleak characterization after advanced endovascular aortic repair

“…Imaging modalities for surveillance after aortic endovascular repair include plain radiography, ultrasound (with or without contrast), CT angiography (classically unenhanced, arterial and delayed phase images), MR angiography, and conventional angiography. 5,6 CT angiography 1 University Health Network and Mount Sinai Hospital, Medical Imaging, Toronto, ON, Canada is the mainstay of surveillance as images are easily reproducible, and the aorta and branches are very well visualized. 7 Conventional triphasic CT provides high sensitivity and specificity for endoleak detection, approximately 85% and 95%, respectively.…”