title: Follow-up of endovascular aortic aneurysm repair: Preliminary validation of digital tomosynthesis and contrast enhanced ultrasound in detection of medium- to long-term complications.
abstract: OBJECTIVE
  To validate the feasibility of digital tomosynthesis of the abdomen (DTA) combined with contrast enhanced ultrasound (CEUS) in assessing complications after endovascular aortic aneurysm repair (EVAR) by using computed tomography angiography (CTA) as the gold standard.
  
  
  METHODS
  For this prospective study we enrolled 163 patients (123 men; mean age, 65.7 years) referred for CTA for EVAR follow-up. CTA, DTA and CEUS were performed at 1 and 12 mo in all patients, with a maximum time interval of 2 d.
  
  
  RESULTS
  Among 163 patients 33 presented complications at CTA. DTA and CTA correlated for the presence of complications in 32/33 (96.96%) patients and for the absence of complications in 127/130 (97.69%) patients; the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DTA were 97%, 98%, 91%, 99%, and 98%, respectively. CEUS and CTA correlated for the presence of complications in 19/33 (57.57%) patients and for the absence of complications in 129/130 (99.23%) patients; the sensitivity, specificity, PPV, NPV and accuracy of CEUS were 58%, 99%, 95%, 90%, and 91%, respectively. Sensitivity, specificity and accuracy of combining DTA and CEUS together in detecting EVAR complications were 77%, 98% and 95%, respectively.
  
  
  CONCLUSIONS
  Combining DTA and CEUS in EVAR follow-up has the potential to limit the use of CTA only in doubtful cases.
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Mazzei
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Guerrini
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Francesco Giuseppe
authors.initials: FG
authors.lastname: Mazzei
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Nevada
authors.initials: N
authors.lastname: Cioffi Squitieri
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Notaro
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Gianmarco
authors.initials: G
authors.lastname: de Donato
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Galzerano
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Palmino
authors.initials: P
authors.lastname: Sacco
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Setacci
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Volterrani
authors.affiliation: Maria Antonietta Mazzei, Susanna Guerrini, Nevada Cioffi Squitieri, Dario Notaro, Luca Volterrani, Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging Unit, University of Siena, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Setacci
keywords: Contrast enhanced ultrasound; Digital tomosynthesis; Endovascular aortic aneurysm repair follow-up; Endovascular aortic replacement