Natural History of the Iliac Arteries after Endovascular Abdominal Aortic Aneurysm Repair and Suitability of Ectatic Iliac Arteries as a Distal Sealing Zone

2007 ◽  
Vol 14 (5) ◽  
pp. 619-624 ◽  
Author(s):  
Juergen Falkensammer ◽  
Albert G. Hakaim ◽  
W. Andrew Oldenburg ◽  
Beate Neuhauser ◽  
Ricardo Paz-Fumagalli ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm Repair ◽  
Pulsatile Blood Flow ◽  
Iliac Arteries ◽  
Abdominal Aortic ◽  
History Of ◽  
Group 2 ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Group 1

Purpose: To investigate the natural history of dilated common iliac arteries (CIA) exposed to pulsatile blood flow after endovascular abdominal aortic aneurysm repair (EVAR) and the suitability of ectatic iliac arteries as sealing zones using flared iliac limbs. Methods: Follow-up computed tomograms of 102 CIAs in 60 EVAR patients were investigated. Diameter changes in CIAs ≤16 mm (group 1) were compared with changes in vessels where a dilated segment >16 mm in diameter continued to be exposed to pulsatile blood flow (group 2). Within group 2, cases in which the stent terminated proximal to the dilated artery segment (2a) were compared with those that had been treated with a flared limb (2b). Results: The mean CIA diameter increased by 1.0±1.0 mm in group 1 (p<0.001 versus immediately after EVAR) and by 1.5±1.7 mm in group 2 (p<0.001 versus immediately after EVAR) within an average follow-up of 43.6±18.0 months. Diameter increase was more pronounced in dilated CIAs (p=0.048), and it was not significantly different between groups 2a and 2b (p=0.188). No late distal type I endoleak or stent-graft migration associated with CIA ectasia was observed. Conclusion: Dilatation of the CIA is significant after EVAR, and it is more pronounced in ectatic iliac arteries. Although ectatic iliac arteries appear to be suitable sealing zones in the short term, continued follow-up is mandatory.

Natural history of periprosthetic air on computerized axial tomographic examination of the abdomen following abdominal aortic aneurysm repair

1984 ◽  
Vol 01 (3) ◽  
pp. 429-433 ◽  
Author(s):  
Patrick J. O'Hara ◽  
Gregory P. Borkowski ◽  
Norman R. Hertzer ◽  
Peter B. O'Donovan ◽  
Susan L. Brigham ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Natural History ◽  
Abdominal Aortic Aneurysm Repair ◽  
Abdominal Aortic ◽  
History Of ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Duplex Ultrasound Surveillance After Uncomplicated Endovascular Abdominal Aortic Aneurysm Repair

2017 ◽  
Vol 51 (5) ◽  
pp. 295-300 ◽  
Author(s):  
Jacob S. Schaeffer ◽  
Irina Shakhnovich ◽  
Kyle N. Sieck ◽  
Kara J. Kallies ◽  
Clark A. Davis ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Predictive Value ◽  
Duplex Ultrasound ◽  
Abdominal Aortic Aneurysm Repair ◽  
Ultrasound Scan ◽  
Abdominal Aortic ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Objectives: Health-care costs and risks of radiation and intravenous contrast exposure challenge computed tomography angiography (CTA) as the standard surveillance method after endovascular abdominal aortic aneurysm repair (EVAR). We reviewed our experience using Duplex ultrasound scan (DUS) as an initial and subsequent surveillance technique after uncomplicated EVAR. Methods: The medical records of patients who underwent EVAR from 2004 to 2014 with at least 1 postoperative imaging study were retrospectively reviewed. Duplex ultrasound scan was the primary modality, with CTA reserved for patients with suspicious findings. Results: Mean follow-up was 3.2 years for 266 patients. Fifty-seven endoleaks (7 type I, 50 type II) were detected in 51 patients (19%). Nineteen (33%) endoleaks were identified and monitored by DUS alone. Nine (16%) endoleaks were identified on CTA without prior DUS. Twenty-two (39%) endoleaks were identified on DUS and confirmed by CTA; 6 of these patients had a secondary intervention. When compared to subsequent CTA, there were 7 discordant results: 4 false-negative and 3 false-positive endoleaks on DUS. Two of these patients with discordant results required intervention. Follow-up CTA was not obtained for the other 2 patients due to severe comorbidities including renal disease. One of these patients eventually developed abdominal aortic aneurysm rupture and death. Among 88 patients with both DUS and CTA, positive predictive value and negative predictive value for DUS were 0.88 and 0.94, respectively. Sac size on DUS compared to CTA resulted in an interclass correlation coefficient of r = .84. Conclusions: In our experience, DUS was safe and effective for initial and follow-up surveillance after uncomplicated EVAR.

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