Background/introduction
Endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) has become established as a minimallyinvasive and effective treatment method.
However,
suitable anatomy of the abdominal aortic aneurysm is required to perform EVAR: long enough section of normal aorta between renal arteries and the aneurysm (infrarenal aortic neck),the aortic neck angle should be less than 60º.
The femoral and iliac arteries need to be wide enough for adequate endograft placement.
Common indications for treatment of the abdominal aortic aneurysm (AAA) are:
aneurysm diameter≥ 5,5 cm or aneurysm...
Description of activity and work performed
The authors performed over 50 CEUS examinations in 27 EVAR patients in 6-month and 12-month period after the treatment.
The CEUS examinations were performed using two-bolus method,
using the first intravenous bolus of contrast media (SonoVue,
1,2 mL) to identify a possible endoleak,
and using the second intravenous bolus of contrast media (SonoVue,
1,2 mL) for further endoleak characterisation (early/late endoleak).
The results were compared with CT-angiography scans.
Endoleak type 2 was detected in three patients (11%),
in two cases caused by retrograde flow via...
Conclusion and recommendations
CEUS is a highly specific and highly sensitive method in EVAR follow-up and endoleak detection,
recommended for EVAR follow-up by EFSUMB.
Ultrasound methods allow for additional information regarding blood flow direction,
characterisation of the blood flow and endoleak classification.
Possible drawbacks for CEUS are the same as the ones regarding B-mode ultrasound: it cannot penetrate thick calcifications of aortic wall,
subcutaneous emphysema or meteoristic bowel may limit the analysis,
and it is more difficult to perform in obese patients.
However,
CEUS significantly reduces radiation exposurein...
Personal/organisational information
The authors'affiliation:
Eugen Divjak - radiology resident at Department of Diagnostic and Interventional Radiology,
University Hospital "Dubrava",
Zagreb
Gordana Ivanac - assistant professor at University of Zagreb School of Medicine; radiology consultant at Department of Diagnostic and Interventional Radiology,
University Hospital "Dubrava",
Zagreb
Boris Brkljačić - professor at University of Zagreb School of Medicine; radiology consultant atDepartment of Diagnostic and Interventional Radiology,
University Hospital "Dubrava",
Zagreb
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