title: Colour Doppler diagnosis of perigraft flow following endovascular repair of abdominal aortic aneurysm.
abstract: BACKGROUND
  Endovascular repair of abdominal aortic aneurysm is a relatively new surgical technique which is less invasive than conventional open abdominal surgery but is associated with a significant specific complication of endoleak. The aim of this study was to determine the accuracy of duplex ultrasound imaging, utilising colour Doppler, as the primary method for post surgical monitoring of endovascular aneurysm repair.
  
  
  METHODS
  
  
  
  METHODS
  a case cohort study of 45 patients undergoing endovascular repair of abdominal aortic aneurysm.
  
  
  METHODS
  angiography, CT scanning and surgery performed at Westmead Hospital, a teaching hospital of the University of Sydney; patients followed postoperatively at the Westmead Vascular Laboratory, a dedicated vascular diagnostic ultrasound facility.
  
  
  METHODS
  Forty males and five females, mean age 69.1 years (range 51 to 84).
  
  
  METHODS
  patients underwent attempted insertion of an EVT (endovascular prosthesis) for exclusion of abdominal aortic aneurysm (mean diameter 5.3 cm; range 4.0 to 8.4 cm). Conversion to open repair was required in three cases (6.6%). An aorto-biliac graft was inserted in 28 patients, a tube graft in eight and an aorto-unilateral iliac graft with femorofemoral (or ilioilial) crossover graft in six.
  
  
  METHODS
  patients were followed over a period of 53 months (median follow-up time 15 months) with 106 colour Doppler scans of 39 endovascular grafts (mean of 2.9 scans per patient).
  
  
  RESULTS
  All aneurysms decreased in diameter (range 0.1 cm to 4.3 cm, mean 0.9 cm). Abnormal flow in the residual aneurysmal sac was found in three patients. In all three cases of endoleak the colour Doppler diagnosis was supported by CT scan and confirmed on angiography. The CT scans did not provide any additional information to that obtained by colour Doppler imaging.
  
  
  CONCLUSIONS
  Colour Doppler provides an effective means of non-invasive follow-up assessment of patients who have had endovascular repair of abdominal aortic aneurysms.
authors: Department of Surgery, University of Sydney, New South Wales, Australia.
authors: J
authors: J
authors: Fletcher
authors: K
authors: K
authors: Saker
authors: P
authors: P
authors: Batiste
authors: S
authors: S
authors: Dyer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color