Intra-operative cone beam computed tomography can help avoid reinterventions and reduce CT follow up after infrarenal EVAR

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
P TörnqvistT Resch

Abstract

Re-interventions after endovascular abdominal aortic aneurysm repair (EVAR) are common and therefore a strict imaging follow up protocol is required. The purpose of this study was to evaluate whether cone beam computed tomography (CBCT) can detect intra-operative complications and to compare this with angiography and the 1 month CT follow up (computed tomography angiography [CTA]). Fifty-one patients (44 men) were enrolled in a prospective trial. Patients underwent completion angiography and CBCT during infrarenal EVAR. Contrast was used except when pre-operative renal insufficiency was present or if the maximum contrast dose threshold was reached. CBCT reconstruction included the top of the stent graft to the iliac bifurcation. Endoleaks, kinks, or compressions were recorded. CBCT was technically successful in all patients. Twelve endoleaks were detected on completion digital subtraction angiography (CA). CBCT detected 4/5 type 1 endoleaks, but only one type 2 endoleak. CTA identified eight type 2 endoleaks and one residual type I endoleak. Two cases of stent compression were seen on CA. CBCT revealed five stent compressions and one kink, which resulted in four intra-operative adjunctive manoeuvres. CTA identified all cases of...Continue Reading

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Citations

Apr 24, 2016·Journal of Vascular Surgery·Christof Johannes SchulzPhilipp Geisbüsch
Jul 5, 2016·Current Treatment Options in Cardiovascular Medicine·John E O'Mara, Robert M Bersin
Dec 3, 2016·Annals of Vascular Surgery·Giuseppe AsciuttoNuno V Dias
Sep 10, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Quirina M B de RuiterJoost A van Herwaarden
Aug 21, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Adrien HertaultStéphan Haulon
May 20, 2016·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Andrea SteuweWolfram Stiller
Mar 28, 2019·The Journal of Cardiovascular Surgery·David LindströmAnders Wanhainen
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Oct 18, 2020·Journal of Vascular Surgery·Marek K KuzniarKevin Mani
Mar 5, 2021·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Giovanni TinelliStéphan Haulon
Aug 10, 2018·Annals of Vascular Surgery·Adrien KaladjiAlain Cardon
Sep 7, 2018·Journal of Vascular Surgery Cases and Innovative Techniques·Aleem K MirzaGustavo S Oderich
Jul 21, 2021·International Angiology : a Journal of the International Union of Angiology·Bharti SinghNuno V Dias

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