Contrast-enhanced ultrasound should be used more frequently for aortic endograft surveillance

Abstract

We commend Motta et al. for their work [1] and were delighted to read their report regarding redefining follow-up protocols after endovascular abdominal aortic aneurysm repair in their prospectively enrolled 88 consecutive patients. We were delighted to see their comparison of the two endovascular aortic aneurysm repair (EVAR) surveillance modalities demonstrating that contrast-enhanced ultrasound scanning (CEUS) of their patients was comparable with the gold standard of computed tomography angiography (CTA). We produced similar results, and we advocate the use of CEUS, as it is better for the EVAR patient and also–in our hands–is cheaper. Questions we have regarding their work concern data regarding the cost of these two modalities and the prospective savings that could be made by introducing CEUS in their EVAR surveillance programme. Also, we would appreciate any information regarding radiation exposure to patients in preoperative EVAR planning, during the actual EVAR procedure itself and during cumulative EVAR surveillance using triple-phase computed tomographic Angiography (CTA). We do not use triphasic CTA for our surveillance programme; instead, we use a reduced biphasic protocol that decreases radiation exposure to our patients. In summary, we found Motta et al.’s study extremely helpful, and it will no doubt help us in our pursuits to implement routine CEUS not only in our practice but in protocols of others in the UK. Information regarding these questions will no doubt increase our efforts to implement this technique more widely. Contrast-enhanced ultrasound should be used more frequently for aortic endograft surveillance