title: [The significance of contrast-enhanced ultrasound in vascular surgery].
abstract: BACKGROUND
  Vascular contrast-enhanced ultrasound (CEUS) is a special ultrasound application without the harmful side effects of nephrotoxicity and radiation exposure. CEUS can be used for advanced diagnosis of carotid stenosis and follow-up checks of endovascular repair of abdominal aortic aneurysms (EVAR). Low-flow phenomenon in peripheral vascular disease can easily be detected by enhanced colour-coded duplex sonography (CCDS).
  
  
  METHODS
  The technical requirements of CEUS are explained here for the aorta, carotid, and peripheral arteries. The benefits and risks compared to computed tomography (CT), magnetic resonance (MR) and angiography are evaluated. Based on a selective review of the literature and the authors' personal experiences, CEUS is recommended for routine surveillance after EVAR.
  
  
  RESULTS
  CEUS is a safe method using SonoVue® (Bracco) as the only approved agent for vascular examination. Special equipment and training is necessary. In prospective studies and meta-analyses the detection and characterisation of endoleaks is comparable to that of CT imaging. Neovascularisation as a sign of carotid plaques at risk can be seen without the need for invasive treatment. Imaging of crural vessels with enhanced CCDS is a promising but rarely needed option in diabetic and renally insufficient patients.
  
  
  CONCLUSIONS
  CEUS in vascular medicine should be performed prior to other methods to avoid nephrotoxic contrast agents for the patients, especially in follow-up checks after EVAR. The time and effort required are still limiting its practical breakthrough.
authors: Gefäß- und Endovaskuläre Chirurgie, Universitätsklinikum Regensburg, Deutschland.
authors: K
authors: K
authors: Pfister
authors: Gefäß- und Endovaskuläre Chirurgie, Universitätsklinikum Regensburg, Deutschland.
authors: P M
authors: PM
authors: Kasprzak
authors: Gefäß- und Endovaskuläre Chirurgie, Universitätsklinikum Regensburg, Deutschland.
authors: H
authors: H
authors: Apfelbeck
authors: Gefäß- und Endovaskuläre Chirurgie, Universitätsklinikum Regensburg, Deutschland.
authors: R
authors: R
authors: Kopp
authors: Gefäß- und Endovaskuläre Chirurgie, Universitätsklinikum Regensburg, Deutschland.
authors: M
authors: M
authors: Janotta
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D018615:Ultrasonography, Doppler, Color; D014652:Vascular Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D014656:Vascular Surgical Procedures
chemical_list: D003287:Contrast Media