title: EVAR: Benefits of CEUS for monitoring stent-graft status.
abstract: Endo vascular aortic repair [EVAR] is performed with low peri-operative morbidity and mortality rate and short hospital stay. However, EVAR needs a close and lifelong imagining surveillance for a timely detection of possible complications including endoleaks, graft migration, fractures, and enlargement of aneurysm sac size with eventual rupture. Contrast enhanced computed tomography [CTA] is actually considered the gold-standard in EVAR follow-up, but it is accompanied with radiation burden and renal injury due to the use of contrast media. In the last two decades several studies have shown the role of contrast enhanced ultrasound [CEUS] in post-EVAR surveillance, with very good diagnostic performance, absence of renal impairment, and no radiation, accompanied by low costs, in comparison with CTA. In numerous prospective studies and meta-analyses the detection and characterization of endoleaks with CEUS is comparable to that of CTA imaging. Nowadays, in the EVAR surveillance novel strategies which involve CEUS with a central role, are suggested by several authors and applied in many institutions. In this review article we will present a comprehensive overview and analyses of the literature on the CEUS state-of-art imagining of EVAR follow-up, with its technique, findings, diagnostic accuracy, and its role in the follow up program.
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy. Electronic address: vito.cantisani@uniroma1.it.
authors.forename: Vito
authors.initials: V
authors.lastname: Cantisani
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Hektor
authors.initials: H
authors.lastname: Grazhdani
authors.affiliation: Interdisciplinary Ultrasound Center, Munich University, Hospital Grosshadern, Munich, Germany.
authors.forename: Dirk-André
authors.initials: DA
authors.lastname: Clevert
authors.affiliation: Policlinico A. Gemelli, Catholic University, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Iezzi
authors.affiliation: Ospedale Valduce, Como, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Aiani
authors.affiliation: Ospedale Valduce, Como, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Martegani
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fanelli
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Di Marzo
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wlderk
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Cirelli
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Leo
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Mattia
authors.initials: M
authors.lastname: Di Segni
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Flavio
authors.initials: F
authors.lastname: Malpassini
authors.affiliation: Department of Radiological, Oncological and Anatomo-Pathological Sciences, Università Sapienza di Roma, Policlinico Umberto I, Rome, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: D'Ambrosio
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D003287:Contrast Media; D057867:Endoleak / Q000000981:diagnostic imaging; D057510:Endovascular Procedures; D006801:Humans; D007089:Image Enhancement; D015607:Stents; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media
keywords: Abdominal aortic aneurysm; Contrast enhanced ultrasound (CEUS); Endovascular abdominal aortic aneurysm repair; Ultrasound contrast agent