title: Duplex Ultrasound versus Computed Tomography for the Postoperative Follow-Up of Endovascular Abdominal Aortic Aneurysm Repair. Where Do We Stand Now?
abstract: In the last decade, endovascular aneurysm repair (EVAR) has rapidly developed to be the preferred method for infrarenal abdominal aortic aneurysm repair in patients with suitable anatomy. EVAR offers the advantage of lower perioperative mortality and morbidity but carries the cost of device-related complications such as endoleak, graft migration, graft thrombosis, and structural graft failure. These complications mandate a lifelong surveillance of EVAR patients and their endografts. The purpose of this study is to review and evaluate the safety of color-duplex ultrasound (CDU) as compared with computed tomography (CT), based on the current literature, for post-EVAR surveillance. The post-EVAR follow-up modalities, CDU versus CT, are evaluated questioning three parameters: (1) accuracy of aneurysm size, (2) detection and classification of endoleaks, and (3) detection of stent-graft deformation. Studies comparing CDU with CT scan for investigation of post-EVAR complications have produced mixed results. Further and long-term research is needed to evaluate the efficacy of CDU versus CT, before CDU can be recommended as the primary imaging modality for EVAR surveillance, in place of CT for stable aneurysms.
authors.affiliation: First Propaedeutic Department of Surgery, Vascular Surgery Unit, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Evridiki
authors.initials: E
authors.lastname: Karanikola
authors.affiliation: Department of Vascular Surgery, University of Athens Medical School, Attikon Hospital, Athens, Greece.
authors.forename: Ilias
authors.initials: I
authors.lastname: Dalainas
authors.affiliation: Second Propaedeutic Department of Surgery, University of Athens Medical School, Laikon Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Karaolanis
authors.affiliation: First Propaedeutic Department of Surgery, Vascular Surgery Unit, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Zografos
authors.affiliation: First Propaedeutic Department of Surgery, Vascular Surgery Unit, University of Athens Medical School, Hippokration Hospital, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Filis
keywords: CDU vs CT; EVAR surveillance; post-EVAR follow-up