Medicina, Vol. 58 No. 3, 2022.
Stručni rad
https://doi.org/10.21860/medflum2022_281003
Can contrast enhanced ultrasound replace computed tomography angiography in endoleak surveillance in post-EVAR patients? – a literature review
Helga Sertić Milić
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Thomas Ferenc
orcid.org/0000-0002-4917-9270
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Ranko Smiljanić
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Vitorio Perić
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Tomica Bratić
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Rhea Marie Mužar
; Klinička bolnica Aarau, Klinički zavod za kirurgiju, Aarau, Švicarska
Darko Blašković
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Nikola Ivan Leder
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska
Vinko Vidjak
orcid.org/0000-0003-3929-3130
; Klinička bolnica Merkur, Klinički zavod za dijagnostičku i intervencijsku radiologiju, Zagreb, Hrvatska, Sveučilište u Zagrebu, Medicinski fakultet, Zagreb, Hrvatska
Sažetak
Aim: Computed tomography angiography (CTA) is the mainstay in endoleak detection after endovascular aneurysm repair (EVAR). The objective of this review is to determine if contrast enhanced ultrasound (CEUS) is able to replace CTA in monitoring endoleaks in patients after EVAR. Materials and methods: The literature search of Englishlanguage articles was conducted in PubMed/MEDLINE, ScienceDirect, Google Scholar. The used keywords included: “Computed tomography angiography”, “Contrast enhanced ultrasound”, “Endovascular aneurysm repair”, “Endoleak”. Studies appearing to meet inclusion criteria were reviewed in full and 39 studies were included. Results: In analysed studies, patients were predominantly men (86%) and median age was 74 years. Endoleak after EVAR was followed in infrarenal (79%), juxtarenal (17%) and suprarenal aneurysms (4%). Endoleak detection rate was 3-52%. Type II endoleaks were the most frequently encountered – in 15% of cases during the first six months and in less than 10% of cases during the first two years after EVAR. In diagnosing all endoleaks, CEUS demonstrated sensitivity, specificity, and AUC of 94%, 88%, 96%, respectively. Compared to CTA, CEUS possesses higher sensitivity (94/83%), but lesser specificity (94.8/99%). Particularly in type II endoleak evaluation, CEUS provided higher detection rates (36.88/20.88%). Regarding type I and type III endoleaks, CEUS demonstrated high sensitivity (97%) and specificity (100%), but without superiority over CTA. Conclusions: CEUS is an imaging technique equivalent to CTA in screening for post-EVAR endoleaks. CTA cannot be entirely replaced by CEUS; however, it is safe and effective alternative method to use after one year of negative CTA exams.
Ključne riječi
aortic aneurysm, abdominal; computed tomography angiography; endoleak; ultrasonography
Hrčak ID:
281003
URI
Datum izdavanja:
1.9.2022.
Posjeta: 761 *