title: Current clinical practice in postoperative endovascular aneurysm repair imaging surveillance.
abstract: OBJECTIVE
  To investigate the current clinical practice in postoperative endovascular aneurysm repair (EVAR) imaging surveillance.
  
  
  METHODS
  Corresponding authors of EVAR publications during the years 2006-2011 and subscribers to an endovascular journal were invited to complete a 27-question online survey related to institutional demographics, standard post-EVAR imaging surveillance, and imaging protocols in special circumstances (eg, renal insufficiency).
  
  
  RESULTS
  The survey was completed by 515 of 9,631 physicians performing EVAR from 52 countries. Of respondents, 65.3% were affiliated with experienced centers where EVAR has been performed for > 10 years or with > 50 EVAR procedures performed per year. Computed tomography (CT) angiography was the modality used most often for standard surveillance with a maximum time interval between studies of 12 months in 78.8% of centers out to 5 years. Experienced centers were more likely to delay follow-up imaging to 1 year after an unremarkable initial post-EVAR imaging study (P < .001), to extend surveillance intervals > 12 months (P = .043), and to use ultrasound (P < .01) for surveillance. After the detection of a type II endoleak, CT angiography was favored for follow-up by 59.4% of the respondents. Experienced centers were more likely to favor ultrasound (P = .006) and to schedule this follow-up examination later (after 6-12 months, P < .001). Of respondents, 62.8% used a glomerular filtration rate threshold of < 30 mL/min for not performing contrast-enhanced CT scan. In patients with renal insufficiency, most respondents performed ultrasound with or without a concomitant noncontrast CT scan.
  
  
  CONCLUSIONS
  CT is the most frequently used method of long-term surveillance after EVAR. Use of ultrasound for long-term surveillance, extension of follow-up time intervals, or both were most often reported in experienced centers.
authors.affiliation: Baptist Cardiac and Vascular Institute, Baptist Hospital of Miami, Miami, FL 33176, USA. uthoffh@uhbs.ch
authors.forename: Heiko
authors.initials: H
authors.lastname: Uthoff
authors.forename: Constantino
authors.initials: C
authors.lastname: Peña
authors.forename: Barry T
authors.initials: BT
authors.lastname: Katzen
authors.forename: Ripal
authors.initials: R
authors.lastname: Gandhi
authors.forename: James
authors.initials: J
authors.lastname: West
authors.forename: James F
authors.initials: JF
authors.lastname: Benenati
authors.forename: Philipp
authors.initials: P
authors.lastname: Geisbüsch
mesh_terms: D000783:Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000009:adverse effects; D003952:Diagnostic Imaging / Q000639:trends*; D057867:Endoleak / Q000175:diagnosis / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects; D019538:Health Care Surveys; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000639:trends; D011182:Postoperative Care / Q000639:trends; D011183:Postoperative Complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011237:Predictive Value of Tests; D051437:Renal Insufficiency / Q000150:complications; D011795:Surveys and Questionnaires; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000639:trends; D014160:Transducers, Pressure / Q000639:trends; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000639:trends
chemical_list: D003287:Contrast Media