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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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  LATEST DEVELOPMENTS IN THE MANAGEMENT OF POST-EVAR COMPLICATIONS


The Journal of Cardiovascular Surgery 2014 October;55(5):563-79

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

State-of-the-art of imaging detecting endoleaks post-EVAR with special focus on low-flow endoleaks

Von Tengg-Kobligk H. 1, 2, Correa Londono M. 1, Von Allmen R. 3, Heverhagen J. T. 1, Van Den Berg J. C. 4

1 University Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University Hospitals Bern, Bern, Switzerland;
2 Department of Diagnostic and Interventional Radiology (DIR), University Hospitals Heidelberg, Heidelberg, Germany;
3 Department for Heart‑ and Vascular Surgery, Inselspital, University Hospitals Bern, Bern, Switzerland;
4 Service of Interventional Radiology, Ospedale Regionale di Lugano, Lugano, Switzerland


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Endovascular aortic repair (EVAR) necessitates lifelong surveillance for the patient, in order to detect complications timely. Endoleaks (ELs) are among the most common complications of EVAR. Especially type II ELs can have a very unpredictable clinical course and this can range from spontaneous sealing to aortic rupture. Subgroups of this type of EL need to be identified in order to make a proper risk stratification. Aim of this review is to describe the existing imaging techniques, including their advantages and disadvantages in the context of post-EVAR surveillance with a particular emphasis on low-flow ELs. Low flow ELs cause pressurization of the aortic aneurysm sac with a low velocity filling, leading to difficulty of detection by routine imaging protocols for EVAR surveillance, e.g. bi- or triphasic multislice computed tomographic angiography, magnetic resonance imaging and contrast enhanced ultrasound. In this article, we review the imaging possibilities of ELs and discuss the different imaging strategies available for depicting low flow ELs.

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hendrik.vontengg@insel.ch