Duplex ultrasound scanning (DUS) versus computed tomography angiography (CTA) in the follow-up after EVAR

Abstract

Introduction: Computed tomography angiography (CTA) is the gold standard follow-up modality after endovascular aneurysm repair (EVAR). A potential alternative noninvasive and less expensive modality is duplex ultrasound scanning (DUS).

Methods: We studied 314 follow-up paired scans (DUS and CTA) in 59 patients with EVAR.

Results: Endoleak--Endoleak was detected in 23.7% patients. The sensitivity and specificity rates of DUS were 54% and 95.3%, respectively. All 9 endoleaks that needed secondary intervention were detected on DUS. Eight of those were identified within a year after EVAR. Sac size--The mean difference in maximum diameter between the DUS and CTA was < or =5 mm in 84.5% of cases and < or =10 mm in 97.1%. Graft patency--There was 100% agreement between CTA and DUS.

Conclusions: Duplex ultrasound scanning was reliable as it detected all the leaks that needed reintervention after EVAR. Duplex ultrasound scanning showed similar results to CTA in detecting sac size and patency.