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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...

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Autores principales: 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
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
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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.
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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
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