Ultrasound with Superb Microvascular Imaging (mSMI) and Contrast-Enhanced Ultrasound (CEUS) in the study of endoleaks in Patients undergoing EVAR: comparison with Computed Tomography Angiography.

Congress:

ECR 2019

Poster Number:

C-3436

Type:

Scientific Exhibit

Keywords:

Diagnostic procedure, Ultrasound-Colour Doppler, Ultrasound, CT-Angiography, Vascular, Interventional vascular, Arteries / Aorta, Aneurysms

Authors:

A. Meli¹, N. Casamassima², E. Macchi¹, F. Piacentino¹, F. Fontana¹, C. Fugazzola¹; ¹Varese/IT, ²Varese , It/IT

DOI:

10.26044/ecr2019/C-3436

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3436

Fig. 1: Patient n° 1: axial CT evidence of type II endoleak which originates from a...

Fig. 2: Patient n° 1: mSMI confirmation of type II endoleak detected with...

Fig. 3: Patient n° 1: endoleak has been also identified with CEUS.

Fig. 4: Patient n° 2: axial CT evidence of type II endoleak which originates from a...

Aims and objectives

The aim of the study was to evaluate the diagnostic effectiveness of superb microvascular imaging (mSMI) compared tocontrast enhancedultrasound (CEUS) and computed tomography multislice angiographyin the identification and classification of endoleaks afterendovascular aneurysmrepair (EVAR).

Methods and materials

From September 2017 to June 2018, 38 Patients treated with EVAR performed a FU using mSMI and CEUS. All patients had previously performed a control with CT-angiography. The population included 36 males (mean age = 77.1 years) and 2 females (mean age = 78.5 years). Evaluation included sac diameter,stent-graftintegrity, identification and classification of endoleaks. Sensitivity, specificity andaccuracy values were evaluated for each modalityof endoleak identification.

Results

No adverse reactions occurred after administration of ultrasound or iodate MdC. mSMI and CEUS documented the patency of the stent-graft in all patients. CT-angiography detected 31 endoleaks; mSMI and CEUS have detected the presence of 29 endoleaks. All identified endoleaks weretype II: 22 originating from a lumbar artery and 9 from the mesenteric artery lower typed with angio-CT; 21 originating from a lumbar artery and 8 from the inferior mesenteric artery typed with mSMI and CEUS. No differences were in the typing of endoleaks between...

Conclusion

Our results allow us to state that mSMI is available for the research of endoleaks; in the future study with numerically larger cases will confirm the role of mSMI as a reference method afterEVAR, significantly reducing the number of CT-angiography (to be reserved for early and 12-month controls) and CEUS (proposed for annual follow-up). Our next objective is to use only mSMI post-EVAR evaluation of the endoleaks after one year from treatment, reserving the CT-angiography only for patients who have a significant dimensional increase of...

Personal information

References

1) Gabriel M “Comparison of Superb Micro-Vascular Ultrasound Imaging (SMI) and Contrast-Enhanced Ultrasound (CEUS) for Detection of Endoleaks After Endovascular Aneurysm Repair (EVAR)” Am J Case Rep, 2016; 17: 43-46 2)Cantisani V “Color Doppler Ultrasound with Superb Microvascular Imaging Compared to Contrast-enhanced Ultrasound and Computed Tomography Angiography to Identify and Classify Endoleaks in Patients Undergoing EVAR” Ann Vasc Surg 2017; 40: 136–145 3)Gabriel M “Superb Micro-vascular Imaging (SMI): a Doppler ultrasound technique with potential to identify, classify, and follow up endoleaks in patients after Endovascular...