1. Multimodality imaging assessment of endoleaks post-endovascular aortic repair
- Author
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Thomas Trischman, Prabhakar Rajiah, Sasan Partovi, Indravadan Patel, Fabian Rengier, Vasileios Rafailidis, Harold Goerne, Brian B. Ghoshhajra, Suvranu Ganguli, Daniel Staub, and George R. Oliveira
- Subjects
medicine.medical_specialty ,Endoleak ,Aortic Diseases ,Contrast Media ,Review Article ,030204 cardiovascular system & hematology ,Aortic repair ,Multimodal Imaging ,Magnetic resonance angiography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Multimodal imaging ,medicine.diagnostic_test ,business.industry ,musculoskeletal, neural, and ocular physiology ,Endovascular Procedures ,Ultrasound ,General Medicine ,Clinical Practice ,Angiography ,cardiovascular system ,Radiology ,business ,psychological phenomena and processes - Abstract
Endoleaks are a common complication of endovascular aortic repair (EVAR). As a result, patients require lifelong imaging surveillance following EVAR. In current clinical practice, evaluation for endoleaks is predominantly performed with CT angiography (CTA). Due to the significant cumulative radiation burden associated with repetitive CTA imaging, as well as the repeated administration of nephrotoxic contrast agent, contrast-enhanced ultrasound (CEUS) and magnetic resonance angiography (MRA) have evolved as potential modalities for lifelong surveillance post-EVAR. In this paper, multimodality imaging, including CTA, CEUS and MRA, for the surveillance of endoleaks is discussed. Further, new CTA techniques for radiation reduction are elaborated. Additionally, imagery for three cases of aortic endoleak detection using CTA and five cases using MRA are presented. Imaging for different types of endoleaks with CTA, MRA and CEUS are presented. For lifelong endoleak surveillance post-EVAR, CTA is still regarded as the imaging modality of choice. However, advancements in CEUS and MRA technique enable partial replacement of CTA in certain patients.
- Published
- 2018