Cargando…
Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature
Introduction: This study evaluated our experience with dynamic computed tomography angiography (dCTA) as a diagnostic tool after endovascular aortic aneurysm repair (EVAR) with respect to the endoleak classification and the available literature. Methods: We reviewed all patients who underwent dCTA b...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10001404/ https://www.ncbi.nlm.nih.gov/pubmed/36899973 http://dx.doi.org/10.3390/diagnostics13050829 |
_version_ | 1784904129399750656 |
---|---|
author | Boer, Gert Jan van Engen, Ludo A. H. van Dam, Lievay van de Luijtgaarden, Koen M. Bokkers, Reinoud P. H. de Vries, Jean-Paul P. M. Fioole, Bram |
author_facet | Boer, Gert Jan van Engen, Ludo A. H. van Dam, Lievay van de Luijtgaarden, Koen M. Bokkers, Reinoud P. H. de Vries, Jean-Paul P. M. Fioole, Bram |
author_sort | Boer, Gert Jan |
collection | PubMed |
description | Introduction: This study evaluated our experience with dynamic computed tomography angiography (dCTA) as a diagnostic tool after endovascular aortic aneurysm repair (EVAR) with respect to the endoleak classification and the available literature. Methods: We reviewed all patients who underwent dCTA because of suspected endoleaks after the EVAR and classified the endoleaks in these patients based on standard CTA (sCTA) and dCTA. We systematically reviewed all available publications that investigated the diagnostic accuracy of dCTA compared with other imaging techniques. Results: In our single-center series, 16 dCTAs were performed in 16 patients. In 11 patients, the undefined endoleaks that appeared on sCTA scans were successfully classified using dCTA. In three patients with a type II endoleak and aneurysm sac growth, inflow arteries were successfully identified using dCTA, and in two patients, aneurysm sac growth was observed without a visible endoleak on both sCTA and dCTA scans. The dCTA revealed four occult endoleaks, all of which were type II endoleaks. The systematic review identified six series comparing dCTA with other imaging methods. All articles reported an excellent outcome regarding the endoleak classification. In published dCTA protocols, the number and timing of phases varied greatly, affecting radiation exposure. Time attenuation curves of the current series show that some phases do not contribute to the endoleak classification and that the use of a test bolus improves the timing of the dCTA. Conclusions: The dCTA is a valuable additional tool that can identify and classify endoleaks more accurately than the sCTA. Published dCTA protocols vary greatly and should be optimized to decrease radiation exposure as long as accuracy can be maintained. The use of a test bolus to improve the timing of the dCTA is recommended, but the optimal number of scanning phases is yet to be determined. |
format | Online Article Text |
id | pubmed-10001404 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100014042023-03-11 Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature Boer, Gert Jan van Engen, Ludo A. H. van Dam, Lievay van de Luijtgaarden, Koen M. Bokkers, Reinoud P. H. de Vries, Jean-Paul P. M. Fioole, Bram Diagnostics (Basel) Systematic Review Introduction: This study evaluated our experience with dynamic computed tomography angiography (dCTA) as a diagnostic tool after endovascular aortic aneurysm repair (EVAR) with respect to the endoleak classification and the available literature. Methods: We reviewed all patients who underwent dCTA because of suspected endoleaks after the EVAR and classified the endoleaks in these patients based on standard CTA (sCTA) and dCTA. We systematically reviewed all available publications that investigated the diagnostic accuracy of dCTA compared with other imaging techniques. Results: In our single-center series, 16 dCTAs were performed in 16 patients. In 11 patients, the undefined endoleaks that appeared on sCTA scans were successfully classified using dCTA. In three patients with a type II endoleak and aneurysm sac growth, inflow arteries were successfully identified using dCTA, and in two patients, aneurysm sac growth was observed without a visible endoleak on both sCTA and dCTA scans. The dCTA revealed four occult endoleaks, all of which were type II endoleaks. The systematic review identified six series comparing dCTA with other imaging methods. All articles reported an excellent outcome regarding the endoleak classification. In published dCTA protocols, the number and timing of phases varied greatly, affecting radiation exposure. Time attenuation curves of the current series show that some phases do not contribute to the endoleak classification and that the use of a test bolus improves the timing of the dCTA. Conclusions: The dCTA is a valuable additional tool that can identify and classify endoleaks more accurately than the sCTA. Published dCTA protocols vary greatly and should be optimized to decrease radiation exposure as long as accuracy can be maintained. The use of a test bolus to improve the timing of the dCTA is recommended, but the optimal number of scanning phases is yet to be determined. MDPI 2023-02-21 /pmc/articles/PMC10001404/ /pubmed/36899973 http://dx.doi.org/10.3390/diagnostics13050829 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Boer, Gert Jan van Engen, Ludo A. H. van Dam, Lievay van de Luijtgaarden, Koen M. Bokkers, Reinoud P. H. de Vries, Jean-Paul P. M. Fioole, Bram Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title | Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title_full | Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title_fullStr | Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title_full_unstemmed | Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title_short | Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature |
title_sort | dynamic computed tomography angiography as imaging method for endoleak classification after endovascular aneurysm repair: a case series and systematic review of the literature |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10001404/ https://www.ncbi.nlm.nih.gov/pubmed/36899973 http://dx.doi.org/10.3390/diagnostics13050829 |
work_keys_str_mv | AT boergertjan dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT vanengenludoah dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT vandamlievay dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT vandeluijtgaardenkoenm dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT bokkersreinoudph dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT devriesjeanpaulpm dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature AT fioolebram dynamiccomputedtomographyangiographyasimagingmethodforendoleakclassificationafterendovascularaneurysmrepairacaseseriesandsystematicreviewoftheliterature |