Multi-detector CT angiographic imaging in the follow-up of patients after endovascular abdominal aortic aneurysm repair (EVAR)

Roberto Iezzi,F Pirro,M Santoro,F Spigonardo,R Dattesi,L Bonomo,M Nestola,A R Cotroneo

doi:10.1007/s13244-012-0173-0

Abstract

BackgroundMultidetector computed tomography (MDCT) angiography represents the standard of reference in the follow-up of patients after endovascular abdominal aortic aneurysm repair (EVAR), being effective in the detection of the full spectrum of possible complications on both axial and 3D images.MethodsThe purpose of this article is to review the normal CT angiography findings of the different types of stent-grafts and to describe the radiological findings of early and late complications after EVAR on axial and reconstructed images. A selection of cases of post-EVAR MDCT angiography is presented to learn the techniques most commonly used for endovascular treatment, the correct CT scanning technique to acquire the data, the full gamut of possible procedure-related complications and how these complications usually appear on CT images.ConclusionMDCT angiography is an effective and specific technique in both the pre- and postoperative settings of EVAR procedures. A better understanding of the procedure, the devices, the normal postoperative imaging features and the possible procedure-related complications ensures optimal planning and follow-up of patients undergoing an EVAR procedure.

Highlights

Endovascular aortic aneurysm repair (EVAR) has developed into a feasible and successful alternative to open surgery for the treatment of abdominal aortic aneurysms
endovascular abdominal aortic aneurysm repair (EVAR) can be offered to many patients with a suitable anatomy of the aorta and iliac arteries, regardless of comorbid conditions [1,2,3]
Because of the rapid diffusion of EVAR and the increased number of patients who undergo multidetector CT (MDCT) follow-up, the radiologist should be familiar with the full spectrum of possible procedure-related complications in order to allow their early diagnosis and treatment

Summary

Introduction

Endovascular aortic aneurysm repair (EVAR) has developed into a feasible and successful alternative to open surgery for the treatment of abdominal aortic aneurysms. Despite the known excellent early results of EVAR in terms of the reduction in perioperative mortality, rate of complications and length of hospitalization, many patients require re-intervention during the middle and long-term follow-up because of procedure-related complications. For this reason, surveillance of these patients is crucial to determine the long-term performance of these devices [4, 5]. Multidetector computed tomography (MDCT) angiography represents the standard of reference in the follow-up of patients after endovascular abdominal aortic aneurysm repair (EVAR), being effective in the detection of the full spectrum of possible complications on both axial and 3D images

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Conclusion