Cargando…
Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair
BACKGROUND: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a c...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725553/ https://www.ncbi.nlm.nih.gov/pubmed/26365968 http://dx.doi.org/10.4103/0366-6999.164935 |
_version_ | 1782411646883332096 |
---|---|
author | Yang, Xiao Chen, Yue-Xin Zhang, Bo Jiang, Yu-Xin Liu, Chang-Wei Zhao, Rui-Na Wu, Qiong Zhang, Da-Ming |
author_facet | Yang, Xiao Chen, Yue-Xin Zhang, Bo Jiang, Yu-Xin Liu, Chang-Wei Zhao, Rui-Na Wu, Qiong Zhang, Da-Ming |
author_sort | Yang, Xiao |
collection | PubMed |
description | BACKGROUND: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a certain percentage of missed diagnosis. Preliminary studies on contrast-enhanced ultrasound (CEUS) have shown that the sensitivity of CEUS for detecting endoleak is no lower than that of CTA. To investigate the advantages of CEUS, we conducted CEUS examinations of post-EVAR cases in which CTA failed to detect endoleak or could not verify the type of endoleak. METHODS: Post-EVAR patients, who were clinically considered to have endoleak and met the inclusion criteria were enrolled between March 2013 and November 2014. All of the patients underwent color Doppler flow imaging (CDFI) and a CEUS examination. Size, location, microbubble dispersion, and hemodynamic characteristics of leaks were recorded. Comparison between the diagnosis of CEUS and CDFI was conducted using Fisher's exact test and clinical outcomes of all patients were followed up. RESULTS: Sixteen patients were enrolled, and 12 (75%) had endoleaks with verified types by CEUS. Among 12 cases of endoleaks were positive by CEUS, 10 were CDFI-positive, and the four CEUS-negative cases were all negative by CDFI. The diagnostic values of CEUS and CDFI were statistically different (P = 0.008). Six patients with high-pressure endoleaks received endovascular re-intervention guided by CEUS results. One patient with type III endoleak had open surgery when endovascular repair failed. CONCLUSIONS: CEUS is a new, safe, and effective means for detection of endoleaks post-EVAR. This technique can be used as a supplement for routine CTA follow-up to provide more detailed information on endoleak and its category. |
format | Online Article Text |
id | pubmed-4725553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-47255532016-04-04 Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair Yang, Xiao Chen, Yue-Xin Zhang, Bo Jiang, Yu-Xin Liu, Chang-Wei Zhao, Rui-Na Wu, Qiong Zhang, Da-Ming Chin Med J (Engl) Original Article BACKGROUND: Endovascular aneurysm repair (EVAR) is one of the first-line therapies of abdominal aortic aneurysms. Postoperative endoleak is the most common complication of EVAR. Computed tomography angiography (CTA), which is routine for follow-up, has side effects (e.g., radiation) and also has a certain percentage of missed diagnosis. Preliminary studies on contrast-enhanced ultrasound (CEUS) have shown that the sensitivity of CEUS for detecting endoleak is no lower than that of CTA. To investigate the advantages of CEUS, we conducted CEUS examinations of post-EVAR cases in which CTA failed to detect endoleak or could not verify the type of endoleak. METHODS: Post-EVAR patients, who were clinically considered to have endoleak and met the inclusion criteria were enrolled between March 2013 and November 2014. All of the patients underwent color Doppler flow imaging (CDFI) and a CEUS examination. Size, location, microbubble dispersion, and hemodynamic characteristics of leaks were recorded. Comparison between the diagnosis of CEUS and CDFI was conducted using Fisher's exact test and clinical outcomes of all patients were followed up. RESULTS: Sixteen patients were enrolled, and 12 (75%) had endoleaks with verified types by CEUS. Among 12 cases of endoleaks were positive by CEUS, 10 were CDFI-positive, and the four CEUS-negative cases were all negative by CDFI. The diagnostic values of CEUS and CDFI were statistically different (P = 0.008). Six patients with high-pressure endoleaks received endovascular re-intervention guided by CEUS results. One patient with type III endoleak had open surgery when endovascular repair failed. CONCLUSIONS: CEUS is a new, safe, and effective means for detection of endoleaks post-EVAR. This technique can be used as a supplement for routine CTA follow-up to provide more detailed information on endoleak and its category. Medknow Publications & Media Pvt Ltd 2015-09-20 /pmc/articles/PMC4725553/ /pubmed/26365968 http://dx.doi.org/10.4103/0366-6999.164935 Text en Copyright: © 2015 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Yang, Xiao Chen, Yue-Xin Zhang, Bo Jiang, Yu-Xin Liu, Chang-Wei Zhao, Rui-Na Wu, Qiong Zhang, Da-Ming Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title_full | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title_fullStr | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title_full_unstemmed | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title_short | Contrast-enhanced Ultrasound in Detecting Endoleaks with Failed Computed Tomography Angiography Diagnosis after Endovascular Abdominal Aortic Aneurysm Repair |
title_sort | contrast-enhanced ultrasound in detecting endoleaks with failed computed tomography angiography diagnosis after endovascular abdominal aortic aneurysm repair |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725553/ https://www.ncbi.nlm.nih.gov/pubmed/26365968 http://dx.doi.org/10.4103/0366-6999.164935 |
work_keys_str_mv | AT yangxiao contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT chenyuexin contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT zhangbo contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT jiangyuxin contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT liuchangwei contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT zhaoruina contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT wuqiong contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair AT zhangdaming contrastenhancedultrasoundindetectingendoleakswithfailedcomputedtomographyangiographydiagnosisafterendovascularabdominalaorticaneurysmrepair |