Duplex Ultrasound Can Successfully Identify Endoleaks and Renovisceral Stent Patency in Patients Undergoing Complex...

Area of Science:

• Vascular Surgery
• Medical Imaging
• Interventional Cardiology

Background:

• Complex endovascular aneurysm repair (EVAR) techniques like FEVAR and ChEVAR require effective postoperative surveillance.
• The role of duplex ultrasound (DU) in monitoring these complex EVAR procedures remains understudied.

Purpose of the Study:

• To evaluate the efficacy of duplex ultrasound (DU) for postoperative surveillance in patients undergoing FEVAR or ChEVAR.
• To compare DU findings with computed tomography angiography (CTA) in detecting complications after complex EVAR.

Main Methods:

• Retrospective review of 82 patients who underwent FEVAR or ChEVAR.
• Postoperative surveillance included DU at 1 month and CTA at 3 months.
• Analysis of DU's ability to detect endoleaks, sac enlargement, and other complications.

Main Results:

• DU identified 3 cases of endoleak with aneurysm sac enlargement requiring reintervention.
• CTA detected 2 new endoleaks without growth and 1 renal artery stent occlusion.
• Replacing initial postoperative imaging with DU did not result in missed endoleaks, deaths, ruptures, or branch occlusions.

Conclusions:

• Duplex ultrasound (DU) is an effective tool for surveillance after complex EVAR (FEVAR, ChEVAR).
• DU can reliably detect significant complications, potentially streamlining postoperative monitoring protocols.
• The findings support the use of DU as a primary imaging modality in the early postoperative period for complex EVAR.