[Endovascular aneurysm repair follow-up by unenhanced and contrast-enhanced duplex ultrasound].
OBJECTIVE
Long-term surveillance is needed after endovascular aneurysm repair to monitor the aneurysm and search for persistent endoleaks. Our aim was to compare follow-up with duplex ultrasound, with and without a new contrast agent to track endoleaks, versus computed tomography angiography taken as the gold standard.


METHODS
Patients treated with endograft were included prospectively from December 2005 to July 2006. Aortic duplex ultrasound and computed tomography were used to measure maximal aneurysm diameter and detect endoleaks. Patients with a high risk of endoleaks had a contrast-enhanced ultrasound with Sonovue (Bracco, Milan, Italy). We compared echographic and tomographic diameter and studied the sensitivity of ultrasound endoleak diagnosis.


RESULTS
Sixty-seven patients were included. There was a good correlation between maximum anteroposterior diameters (CCI=0.98) measured by ultrasound and tomography, as well as mean maximum cross section diameters (CCI=0.96). Compared to tomography, the sensitivity of ultrasound endoleaks diagnosis was 44% (kappa=0.58). Contrast injection improved this sensitivity significantly (p<0.001) (sensitivity=88%; kappa=0.72).


CONCLUSIONS
These findings confirmed the performance of our ultrasound method for endograft surveillance. Contrast-enhanced ultrasound significantly improves the sensitivity of detection of endoleaks. We suggest alternating ultrasound and tomographic exams. A unique report chart for use nationwide would be useful for standardizing follow-up.
Sarlon
G
G
Service de chirurgie et médecine vasculaire, hôpital la Timone, Assistance publique-Hôpitaux de Marseille, faculté de médecine de Marseille, université de la Méditerranée, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. gabriellesarlon@yahoo.fr
Lapierre
F
F
Sarlon
E
E
Bartoli
M-A
MA
Magnan
P E
PE
Branchereau
A
A
D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003327:Coronary Disease / Q000150:complications; D015150:Echocardiography, Doppler; D018618:Echocardiography, Doppler, Color; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications; D006801:Humans; D051437:Renal Insufficiency / Q000150:complications; D014057:Tomography, X-Ray Computed; D018616:Ultrasonography, Doppler, Duplex