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Related Experiment Video

Updated: May 5, 2026

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Individualizing Surveillance after Endovascular Aortic Repair Using a Modular Imaging Algorithm.

Amun Georg Hofmann1, Irene Mlekusch1, Georg Wickenhauser1

  • 1Department of Vascular and Endovascular Surgery, Klinik Ottakring, Montleartstraße 37, 1160 Vienna, Austria.

Diagnostics (Basel, Switzerland)
|May 11, 2024
PubMed
Summary
This summary is machine-generated.

A new modular imaging algorithm personalizes surveillance after endovascular aortic repair (EVAR) and fenestrated EVAR (FEVAR). This approach reduces unnecessary advanced imaging, improving efficiency and patient care.

Keywords:
EVARFEVARendovascular aortic repairimagingultrasound

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Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Health Informatics

Background:

  • Current surveillance for endovascular aortic repair (EVAR) and fenestrated EVAR (FEVAR) lacks personalization.
  • Treatment strategies are individualized, but follow-up imaging often uses a one-size-fits-all approach.

Purpose of the Study:

  • To propose and evaluate a modular imaging algorithm for personalized surveillance after EVAR and FEVAR.
  • To escalate imaging intensity based on invasiveness and clinical need.

Main Methods:

  • Retrospective analysis of a single-center cohort of EVAR and FEVAR patients.
  • Implementation of a modular imaging algorithm starting with B-mode ultrasound, progressing to Duplex ultrasound, B-Flow, and contrast-enhanced ultrasound (CEUS).
  • CT angiography (CTA) used when necessary; comparative analysis of endoleak detection rates.

Main Results:

  • The study included 28 EVAR and 40 FEVAR patients, with 101 follow-up visits and 431 imaging studies.
  • Contrast-enhanced ultrasound (CEUS) demonstrated the highest endoleak detection rate, followed by CTA and B-Flow.
  • Duplex ultrasound and B-Flow showed low false positive rates (0 and 1, respectively); CEUS was the reference standard.
  • In six patients, CEUS was omitted after positive endoleak identification by Duplex or B-Flow, leading to successful treatment and no adverse events.

Conclusions:

  • The modular imaging algorithm supports personalized medicine in post-EVAR/FEVAR surveillance.
  • Less invasive and resource-intensive imaging like Duplex ultrasound and B-Flow can potentially replace advanced modalities (CEUS, CTA) for endoleak detection when positive.
  • This approach can optimize resource utilization and patient management.