scholarly journals Duplex Ultrasound Versus Computed Tomography for Follow Up of Complications after Evar with Nellix Endograft: First Clinical Experience

2013 ◽  
Vol 13 (1) ◽  
pp. 28-33
Author(s):  
Natalija Ezite ◽  
Janis Savlovskis ◽  
Marcis Gedins ◽  
Kaspars Kisis ◽  
Polina Dombure ◽  
...  

Summary Introduction.Contrast-enhanced computed tomography (CT) has become the ‘gold-standard’ imaging modality for surveillance following EVAR (2, 20). However repeated CT is related to increased cost, risk of contrast nephropathy and radiation exposure. Duplex ultrasound (DUS) is a less invasive but considered less accurate method than CT. Aim of the study. The aim of this study was to determine the diagnostic accuracy of both imaging modalities for detection of complications in post-EVAR patients where the new generation sac-sealing endograft was used and to compare cost-effectiveness and sensitivity of both imaging modalities. Methods. Analysis of 23 post-EVAR patients with implantation of new generation sac-sealing endograft device (Nellix®, Endologix, USA) was performed, making a comparison of CT and DUS. Contrast-enhanced computed tomography was taken as the ‘goldstandard’ investigation. DUS was compared to CT for analysis of sensitivity, post-imaging complications and cost-effectiveness. Statistical analysis of data was performed using v19.0 SPSS software (IBM). Results. Analysis of CT and DUS studies compared in 23 patients. Both imaging modalities can detect AAA sac dimensions, endoleaks, and graft patency. The cost difference between two imaging techniques is substantial. Our results demonstrate that DUS surveillance during follow-up after EVAR where new generation sac-sealing endograft is used can accurately detect aneurysm size, endoleaks, graft deformations and stenotic or kinked graft limbs while lowering the overall costs of surveillance and eliminating CT related radiation and nephrotoxicity. Conclusion. CT and DUS imaging can both detect AAA sac dimensions, endoleaks, and graft patency. The cost difference between the two imaging techniques is substantial. Our results demonstrate that in post-EVAR patients where new-generation sac-sealing endograft was deployed DUS surveillance performed by experienced radiologist can accurately detect aneurysm size, endoleaks, graft deformations and stenotic or kinked graft limbs while lowering the overall costs of surveillance and avoiding CT-related complications.

2020 ◽  
Vol 73 (1-2) ◽  
pp. 29-35
Author(s):  
Aleksandar Spasic ◽  
Viktor Till ◽  
Marijana Basta-Nikolic ◽  
Djordje Milosevic ◽  
Darka Hadnadjev-Simonji ◽  
...  

Introduction. Imaging is essential in the assessment of endovascular infrarenal abdominal aortic repair results. Complications include endoleaks, graft migration, kinking and infolding, stenosis, occlusion, and secondary ruptures. Examination Modalities. Contemporary imaging strategies are based on using noninvasive imaging modalities. After endovascular infrarenal abdominal aortic repair, the standard evaluation modality is computed tomography angiography, whereas additional modalities include magnetic resonance imaging, ultrasonography, and radiography. However, although an invasive imaging method, digital subtraction angiography is still performed in some patients. Computed tomography angiography provides excellent contrast, spatial resolution, and exact measurements of structures of interest, which is essential in the follow-up. Follow-up Protocol. Currently recommended follow-up protocol in the first year is contrast- enhanced computed tomography imaging at 1 and 12 months after the procedure. Conclusion. Due to its characteristics, reproducibility and availability, computed tomography angiography remains the cornerstone diagnostic modality of post-procedural assessment in patients with endovascular infrarenal abdominal aortic repair.


2019 ◽  
Vol 36 (1) ◽  
pp. 37-44
Author(s):  
Jessica T. Prince

This review explores the classification and evaluation of suspicious renal lesions across several radiologic imaging modalities. Diagnostic medical sonography (DMS), computed tomography (CT), magnetic resonance imaging (MRI), and contrast-enhanced ultrasound (CEUS) are the primary modalities used to investigate questionable lesions found within the kidneys. Renal masses may range from completely benign to malignant. They are classified based on many different features and characteristics. These lesions may be simple cystic, complex cystic, or solid in nature. Masses may also exhibit varying degrees of vascularity, septations, and calcifications. The discussed imaging modalities have varying strengths, limitations, and implications for use. Imaging techniques may be used independently or in conjunction to best diagnose and treat a patient with a suspicious renal mass. The aim of this review was to describe the diagnostic value of the imaging modalities (DMS, CT, MRI, and CEUS) and their role in the evaluation of suspicious renal lesions.


1997 ◽  
Vol 4 (3) ◽  
pp. 312-315 ◽  
Author(s):  
Greg van Schie ◽  
Kishore Sieunarine ◽  
Mike Holt ◽  
Michael Lawrence-Brown ◽  
David Hartley ◽  
...  

Purpose: To report the successful endovascular occlusion of a persistent endoleak owing to collateral perfusion in a 1-year-old bifurcated aortic endograft. Methods and Results: An 81-year-old man underwent endovascular repair of a 5.5-cm abdominal aortic aneurysm (AAA) with a bifurcated stent-graft in 1995; collateral perfusion of the excluded aneurysm by retrograde filling of the patent inferior mesenteric artery (IMA) was noted postoperatively. At his 1-year follow-up, the mid-sac endoleak persisted on contrast-enhanced computed tomography. Using the superior mesenteric artery for access, the stump of the IMA was successfully embolized with glue. Conclusions: This case, which highlights the importance of documenting a patent IMA prior to AAA endografting, illustrates one option for the management of persistent collateral perfusion of endovascularly excluded aneurysms.


2012 ◽  
Vol 48 (6) ◽  
pp. 390-398 ◽  
Author(s):  
Katherine J. Anders ◽  
Mary A. McLoughlin ◽  
Valerie F. Samii ◽  
Dennis J. Chew ◽  
Karin L. Cannizzo ◽  
...  

Ureteral ectopia is a well-described cause of urinary incontinence in female dogs, but this condition has not been completely characterized in male dogs. Sixteen male dogs with ectopic ureters were evaluated between Jan 1999 and Mar 2007. Male dogs were similar to female dogs with ectopic ureters in terms of breed, presenting complaint, age of onset, and bilateral nature of the ectopia. Diagnosis was made by expert interpretation of imaging techniques such as excretory urography and contrast-enhanced computed tomography (CT). Overall, 11 of 13 dogs that had surgical correction of ectopic ureters were incontinent preoperatively. Urinary continence was restored in 82% of those dogs.


Sign in / Sign up

Export Citation Format

Share Document