Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000068.xml
Semin intervent Radiol 2015; 32(03): 239-248
DOI: 10.1055/s-0035-1556878
DOI: 10.1055/s-0035-1556878
Surveillance Imaging Following Endovascular Aneurysm Repair
Further Information
Publication History
Publication Date:
18 August 2015 (online)
![](https://www.thieme-connect.de/media/sir/201503/lookinside/thumbnails/10-1055-s-0035-1556878_00901-1.jpg)
Abstract
There is a significant risk of complication following endovascular abdominal repair (EVAR), including endoleak, graft translocation, thrombosis, and infection. Surveillance imaging is important for detecting EVAR complication. Surveillance modalities include conventional X-ray, computed tomography, magnetic resonance imaging, ultrasound, and conventional angiography, with inherent advantages and drawbacks to each modality. The authors present common complications following EVAR, and recent advances in the key modalities for surveillance.
-
References
- 1 Singh K, Bønaa KH, Jacobsen BK, Bjørk L, Solberg S. Prevalence of and risk factors for abdominal aortic aneurysms in a population-based study: The Tromsø Study. Am J Epidemiol 2001; 154 (3) 236-244
- 2 McPhee JT, Hill JS, Eslami MH. The impact of gender on presentation, therapy, and mortality of abdominal aortic aneurysm in the United States, 2001-2004. J Vasc Surg 2007; 45 (5) 891-899
- 3 Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5 (6) 491-499
- 4 Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG ; EVAR trial participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 2004; 364 (9437) 843-848
- 5 Schermerhorn ML, O'Malley AJ, Jhaveri A, Cotterill P, Pomposelli F, Landon BE. Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med 2008; 358 (5) 464-474
- 6 Ng TT, Mirocha J, Magner D, Gewertz BL. Variations in the utilization of endovascular aneurysm repair reflect population risk factors and disease prevalence. J Vasc Surg 2010; 51 (4) 801-809 , 809.e1
- 7 Vandy F, Upchurch Jr GR. Endovascular aneurysm repair: current status. Circ Cardiovasc Interv 2012; 5 (6) 871-882
- 8 d'Audiffret A, Desgranges P, Kobeiter DH, Becquemin JP. Follow-up evaluation of endoluminally treated abdominal aortic aneurysms with duplex ultrasonography: validation with computed tomography. J Vasc Surg 2001; 33 (1) 42-50
- 9 Vallabhaneni SR, Harris PL. Lessons learnt from the EUROSTAR registry on endovascular repair of abdominal aortic aneurysm repair. Eur J Radiol 2001; 39 (1) 34-41
- 10 White GH, Yu W, May J. Endoleak—a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft. J Endovasc Surg 1996; 3 (1) 124-125
- 11 Stavropoulos SW, Baum RA. Imaging modalities for the detection and management of endoleaks. Semin Vasc Surg 2004; 17 (2) 154-160
- 12 Stavropoulos SW, Clark TW, Carpenter JP , et al. Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol 2005; 16 (5) 663-667
- 13 Stavropoulos SW, Charagundla SR. Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. Radiology 2007; 243 (3) 641-655
- 14 Aburahma AF, Campbell JE, Mousa AY , et al. Clinical outcomes for hostile versus favorable aortic neck anatomy in endovascular aortic aneurysm repair using modular devices. J Vasc Surg 2011; 54 (1) 13-21
- 15 Liaw JV, Clark M, Gibbs R, Jenkins M, Cheshire N, Hamady M. Update: Complications and management of infrarenal EVAR. Eur J Radiol 2009; 71 (3) 541-551
- 16 Ueda T, Takaoka H, Petrovitch I, Rubin GD. Detection of broken sutures and metal-ring fractures in AneuRx stent-grafts by using three-dimensional CT angiography after endovascular abdominal aortic aneurysm repair: association with late endoleak development and device migration. Radiology 2014; 272 (1) 275-283
- 17 Veith FJ, Baum RA, Ohki T , et al. Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference. J Vasc Surg 2002; 35 (5) 1029-1035
- 18 Nolz R, Teufelsbauer H, Asenbaum U , et al. Type II endoleaks after endovascular repair of abdominal aortic aneurysms: fate of the aneurysm sac and neck changes during long-term follow-up. J Endovasc Ther 2012; 19 (2) 193-199
- 19 Güntner O, Zeman F, Wohlgemuth WA , et al. Inferior mesenteric arterial type II endoleaks after endovascular repair of abdominal aortic aneurysm: are they predictable?. Radiology 2014; 270 (3) 910-919
- 20 Filippi F, Tirotti C, Stella N, Rizzo L, Taurino M. Endotension-related aortic sac rupture treated by endograft relining. Vascular 2013; 21 (2) 113-115
- 21 Ricotta II JJ. Endoleak management and postoperative surveillance following endovascular repair of thoracic aortic aneurysms. J Vasc Surg 2010; 52 (4, Suppl): 91S-99S
- 22 Carpenter JP, Anderson WN, Brewster DC , et al; Lifepath Investigators. Multicenter pivotal trial results of the Lifepath System for endovascular aortic aneurysm repair. J Vasc Surg 2004; 39 (1) 34-43
- 23 Sampaio SM, Panneton JM, Mozes G , et al. AneuRx device migration: incidence, risk factors, and consequences. Ann Vasc Surg 2005; 19 (2) 178-185
- 24 Carroccio A, Faries PL, Morrissey NJ , et al. Predicting iliac limb occlusions after bifurcated aortic stent grafting: anatomic and device-related causes. J Vasc Surg 2002; 36 (4) 679-684
- 25 Maleux G, Koolen M, Heye S, Nevelsteen A. Limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts. J Vasc Interv Radiol 2008; 19 (10) 1409-1412
- 26 Hellinger JC. Endovascular repair of thoracic and abdominal aortic aneurysms: pre- and postprocedural imaging. Tech Vasc Interv Radiol 2005; 8 (1) 2-15
- 27 Sharif MA, Lee B, Lau LL , et al. Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair. J Vasc Surg 2007; 46 (3) 442-448
- 28 Ducasse E, Calisti A, Speziale F, Rizzo L, Misuraca M, Fiorani P. Aortoiliac stent graft infection: current problems and management. Ann Vasc Surg 2004; 18 (5) 521-526
- 29 Fatima J, Duncan AA, de Grandis E , et al. Treatment strategies and outcomes in patients with infected aortic endografts. J Vasc Surg 2013; 58 (2) 371-379
- 30 van den Berg HR, Leijdekkers VJ, Vahl A. Aortic stent-graft infection following septic complications of a kidney stone. Cardiovasc Intervent Radiol 2006; 29 (3) 443-445
- 31 Saratzis N, Saratzis A, Melas N, Ktenidis K, Kiskinis D. Aortoduodenal fistulas after endovascular stent-graft repair of abdominal aortic aneurysms: single-center experience and review of the literature. J Endovasc Ther 2008; 15 (4) 441-448
- 32 Röntgen WC. On a New Kind of Rays: translation of a paper read before the Würzburg Physical and Medical Society. Nature 1895; 53: 274-276
- 33 Fearn S, Lawrence-Brown MMD, Semmens JB, Hartley D. Follow-up after endovascular aortic aneurysm repair: the plain radiograph has an essential role in surveillance. J Endovasc Ther 2003; 10 (5) 894-901
- 34 Harrison GJ, Oshin OA, Vallabhaneni SR, Brennan JA, Fisher RK, McWilliams RG. Surveillance after EVAR based on duplex ultrasound and abdominal radiography. Eur J Vasc Endovasc Surg 2011; 42 (2) 187-192
- 35 Hodgson R, McWilliams RG, Simpson A , et al. Migration versus apparent migration: importance of errors due to positioning variation in plain radiographic follow-up of aortic stent-grafts. J Endovasc Ther 2003; 10 (5) 902-910
- 36 Viano AM, Gronemeyer SA, Haliloglu M, Hoffer FA. Improved MR imaging for patients with metallic implants. Magn Reson Imaging 2000; 18 (3) 287-295
- 37 van der Vliet JA, Kool LJ, van Hoek F. Simplifying post-EVAR surveillance. Eur J Vasc Endovasc Surg 2011; 42 (2) 193-194
- 38 Bobadilla JL, Suwanabol PA, Reeder SB, Pozniak MA, Bley TA, Tefera G. Clinical implications of non-contrast-enhanced computed tomography for follow-up after endovascular abdominal aortic aneurysm repair. Ann Vasc Surg 2013; 27 (8) 1042-1048
- 39 Armerding MD, Rubin GD, Beaulieu CF , et al. Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography. Radiology 2000; 215 (1) 138-146
- 40 Iezzi R, Cotroneo AR, Filippone A , et al. Multidetector CT in abdominal aortic aneurysm treated with endovascular repair: are unenhanced and delayed phase enhanced images effective for endoleak detection?. Radiology 2006; 241 (3) 915-921
- 41 Shah A, Stavropoulos SW. Imaging surveillance following endovascular aneurysm repair. Semin Intervent Radiol 2009; 26 (1) 10-16
- 42 Picel AC, Kansal N. Essentials of endovascular abdominal aortic aneurysm repair imaging: postprocedure surveillance and complications. AJR Am J Roentgenol 2014; 203 (4) 358-372
- 43 Macari M, Chandarana H, Schmidt B, Lee J, Lamparello P, Babb J. Abdominal aortic aneurysm: can the arterial phase at CT evaluation after endovascular repair be eliminated to reduce radiation dose?. Radiology 2006; 241 (3) 908-914
- 44 Wintersperger B, Jakobs T, Herzog P , et al. Aorto-iliac multidetector-row CT angiography with low kV settings: improved vessel enhancement and simultaneous reduction of radiation dose. Eur Radiol 2005; 15 (2) 334-341
- 45 Back MR. Surveillance after endovascular repair. Perspect Vasc Surg Endovasc Ther 2007; 19: 395-400
- 46 Hansen NJ, Kaza RK, Maturen KE, Liu PS, Platt JF. Evaluation of low-dose CT angiography with model-based iterative reconstruction after endovascular aneurysm repair of a thoracic or abdominal aortic aneurysm. AJR Am J Roentgenol 2014; 202 (3) 648-655
- 47 Flors L, Leiva-Salinas C, Norton PT, Patrie JT, Hagspiel KD. Endoleak detection after endovascular repair of thoracic aortic aneurysm using dual-source dual-energy CT: suitable scanning protocols and potential radiation dose reduction. AJR Am J Roentgenol 2013; 200 (2) 451-460
- 48 Schindera ST, Graca P, Patak MA , et al. Thoracoabdominal-aortoiliac multidetector-row CT angiography at 80 and 100 kVp: assessment of image quality and radiation dose. Invest Radiol 2009; 44 (10) 650-655
- 49 Utsunomiya D, Oda S, Funama Y , et al. Comparison of standard- and low-tube voltage MDCT angiography in patients with peripheral arterial disease. Eur Radiol 2010; 20 (11) 2758-2765
- 50 Haulon S, Lions C, McFadden EP , et al. Prospective evaluation of magnetic resonance imaging after endovascular treatment of infrarenal aortic aneurysms. Eur J Vasc Endovasc Surg 2001; 22 (1) 62-69
- 51 Ayuso JR, de Caralt TM, Pages M , et al. MRA is useful as a follow-up technique after endovascular repair of aortic aneurysms with nitinol endoprostheses. J Magn Reson Imaging 2004; 20 (5) 803-810
- 52 Pandey N, Cook T, Stavropoulos SW , et al. Imaging surveillance for recurrent endoleak after prior embolization. Paper presented at the Annual Meeting for the North American Society for Cardiovascular Imaging; October 1, 2013; Atlanta, GA
- 53 Habets J, Zandvoort HJ, Reitsma JB , et al. Magnetic resonance imaging is more sensitive than computed tomography angiography for the detection of endoleaks after endovascular abdominal aortic aneurysm repair: a systematic review. Eur J Vasc Endovasc Surg 2013; 45 (4) 340-350
- 54 Lookstein RA, Goldman J, Pukin L, Marin ML. Time-resolved magnetic resonance angiography as a noninvasive method to characterize endoleaks: initial results compared with conventional angiography. J Vasc Surg 2004; 39 (1) 27-33
- 55 Alerci M, Oberson M, Fogliata A, Gallino A, Vock P, Wyttenbach R. Prospective, intraindividual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms. Eur Radiol 2009; 19 (5) 1223-1231
- 56 Cohen EI, Weinreb DB, Siegelbaum RH , et al. Time-resolved MR angiography for the classification of endoleaks after endovascular aneurysm repair. J Magn Reson Imaging 2008; 27 (3) 500-503
- 57 Cornelissen SA, Prokop M, Verhagen HJ, Adriaensen ME, Moll FL, Bartels LW. Detection of occult endoleaks after endovascular treatment of abdominal aortic aneurysm using magnetic resonance imaging with a blood pool contrast agent: preliminary observations. Invest Radiol 2010; 45 (9) 548-553
- 58 Wieners G, Meyer F, Halloul Z , et al. Detection of type II endoleak after endovascular aortic repair: comparison between magnetic resonance angiography and blood-pool contrast agent and dual-phase computed tomography angiography. Cardiovasc Intervent Radiol 2010; 33 (6) 1135-1142
- 59 van Bogerijen GH, van Herwaarden JA, Conti M , et al. Importance of dynamic aortic evaluation in planning TEVAR. Ann Cardiothorac Surg 2014; 3 (3) 300-306
- 60 Grobner T. Gadolinium—a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis?. Nephrol Dial Transplant 2006; 21 (4) 1104-1108
- 61 Resta EC, Secchi F, Giardino A , et al. Non-contrast MR imaging for detecting endoleak after abdominal endovascular aortic repair. Int J Cardiovasc Imaging 2013; 29 (1) 229-235
- 62 Nyheim T, Staxrud LE, Rosen L, Slagsvold CE, Sandbaek G, Jørgensen JJ. Review of postoperative CT and ultrasound for endovascular aneurysm repair using Talent stent graft: can we simplify the surveillance protocol and reduce the number of CT scans?. Acta Radiol 2013; 54 (1) 54-58
- 63 Millen A, Canavati R, Harrison G , et al. Defining a role for contrast-enhanced ultrasound in endovascular aneurysm repair surveillance. J Vasc Surg 2013; 58 (1) 18-23
- 64 Chung YE, Kim KW. Contrast-enhanced ultrasonography: advance and current status in abdominal imaging. Ultrasonography 2014; 34 (1) 3-18
- 65 Kranokpiraksa P, Kaufman JA. Follow-up of endovascular aneurysm repair: plain radiography, ultrasound, CT/CT angiography, MR imaging/MR angiography, or what?. J Vasc Interv Radiol 2008; 19 (6, Suppl): S27-S36
- 66 Ashoke R, Brown LC, Rodway A , et al. Color duplex ultrasonography is insensitive for the detection of endoleak after aortic endografting: a systematic review. J Endovasc Ther 2005; 12 (3) 297-305
- 67 Raman KG, Missig-Carroll N, Richardson T, Muluk SC, Makaroun MS. Color-flow duplex ultrasound scan versus computed tomographic scan in the surveillance of endovascular aneurysm repair. J Vasc Surg 2003; 38 (4) 645-651
- 68 Iezzi R, Cotroneo AR, Basilico R, Simeone A, Storto ML, Bonomo L. Endoleaks after endovascular repair of abdominal aortic aneurysm: value of CEUS. Abdom Imaging 2010; 35 (1) 106-114
- 69 Bangalore S, Bhatt DL. Femoral arterial access and closure. Circulation 2011; 124 (5) e147-e156
- 70 Baum RA, Carpenter JP, Golden MA , et al. Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: comparison of transarterial and translumbar techniques. J Vasc Surg 2002; 35 (1) 23-29
- 71 Choi SY, Won JY, Lee Y, Choi D, Shim WH, Lee KH. Percutaneous transabdominal approach for the treatment of endoleaks after endovascular repair of infrarenal abdominal aortic aneurysm. Korean J Radiol 2010; 11 (1) 107-114