Predicting Endoleaks Following Endovascular Aortic Aneurysm Repair Using 18F-Sodium Fluoride
Conditions: Abdominal Aortic Aneurysm; Endoleak; Stent-Graft Endoleak Interventions: Diagnostic Test: 18F Sodium Fluoride Positron Emission Tomography / Computed Tomography; Diagnostic Test: CT Aortic Angiogram; Diagnostic Test: 12-month CT Aortic Angiogram; Other: 24-month review Sponsors: University of Edinburgh; NHS Lothian; NHS Greater Glasgow and Clyde; NHS Lanarkshire; NHS Tayside Not yet recruiting
Objectives The aim of this study was to compare image quality, conspicuity, and endoleak detection between single-energy low-kV images (SEIs) and dual-energy low-keV virtual monoenergetic images (VMIs+) in computed tomography angiography of the aorta after endovascular repair. Materials and Methods An abdominal aortic aneurysm phantom simulating 36 endoleaks (2 densities; diameters: 2, 4, and 6 mm) in a medium- and large-sized patient was used. Each size was scanned using single-energy at 80 kVp (A) and 100 kVp (B), and dual-energy at 80/Sn150kVp for the medium (C) and 90/Sn150kVp for the large size (D). VMIs+ at 40 k...
ConclusionsThis study identified the sources of fusion error after insertion of rigid material during EVAR. As the sharpest angulation between aneurysm neck and sac increases, the overall accuracy of the fusion might be affected.
ConclusionsRRED was smaller than the actual diameter in more than half of pre-rupture AAAs, suggesting a lower rupture risk than estimated with the actual diameter. The results suggest that the currently available biomechanical imaging markers might not be ready for use in clinical practice.
ConclusionEvidences from this study suggest that contrast-enhanced ultrasound scan post-EVAR can be utilised as safe and effective method in screening for endoleaks during post-EVAR surveillance without exposing the patient for additional risk of radiation and contrast. CEUS conveys no inferiority to CTA in detecting endoleaks.
The objective of this study is to determine the utility of the 1-month CTA following elective EVAR and determine if initial surveillance at 6-month CTA is appropriate.
The objective of this study is to determine the utility of the one month CTA following elective EVAR and determine if initial surveillance at six-months CTA is appropriate.
We present a case of a type Ia endoleak detected using 18F-FDG PET/CT 10 years after an abdominal aortoiliac endovascular aneurysm repair in an 83-year-old man. The 18F-FDG PET/CT scan was performed to evaluate a solitary pulmonary nodule but, in addition, demonstrated unexpected blood pool activity outside the stent graft and within the abdominal aortic aneurysm sac, indicating an endoleak; no FDG activity should be present within the aneurysm sac after stent graft placement. A subsequent CT angiogram confirmed the endoleak. This case illustrates the value of PET/CT in unexpectedly demonstrating this serious, late complic...
ConclusionsOur limited experience seems to reveal that a cutoff of ≤ 20 mm for AB diameter, as in current guidelines, is ineffective in predicting outcomes after EVAR.
Abstract BACKGROUND: People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast-enhanced CDUS (CE-CDUS) are less invasive but considered less accurate than CT. OBJECTIVES: To determine the diagnostic accuracy of colour duplex ultrasound (CDUS) and contrast-enhanced-colour duplex ultrasound (CE-CDUS)...
ConclusionsUsing the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification.Key Points•A single-acquisition, split-bolus approach allows for a significant dose reduction.•Endoleak development is the most common complication after endovascular aortic repair (EVAR).•CT angiography is the imaging modality of choice for aortic aneurysm evaluation.