[The value of color doppler ultrasonography in the diagnosis of endograft infections following endovascular aneurysm repair].

Abstract

Objective: To study the value of color doppler ultrasonography (CDU) in the diagnosis of endograft infections following endovascular aneurysm repair (EVAR). Methods: The retrospective analysis of post-EVAR stent infections identified by computed tomography angiography (CTA) was conducted at the First Affiliated Hospital of Sun Yat-sen University from January 2010 to December 2020. There were 16 males and 4 females, aged from 49 to 86 years. All the patients were detected by CDU. The endoleak, bubbles, abscess, hematoma, aortic intestinal fistula (AEF) and occlusion of stent detected by CTA and CDU were analyzed and compared. Results: Among 20 patients, 9 cases with endoleak were detected by CTA, while CDU showed 8 cases with endoleak. The rate of missed diagnosis was 1/9. The misdiagnosis rate was 0, and the Youden index was 0.89. CDU detected 3 cases with type Ⅱ endoleak, and 1 case was missed when compared with CTA. Three cases with type Ⅰa and 2 cases with type Ⅰb were detected by CDU, which were consistent with those of CTA. CDU and CTA showed that there were no cases with type Ⅲ and type Ⅳ endoleaks. CDU detected 8 cases with bubbles in the sac. Compared with CTA, the rate of missed diagnosis was 2/10. The misdiagnosis rate was 0, and the Youden index was 0.80. The cases with abscess, hematoma, increasing size of the aneurysm, occlusion of stent and fluid sonolucent area in the sac detected by CDU were 8/20, 2/20, 4/20, 1/20, 2/20, which were consistent with CTA. CDU did not detect the 3 cases with aortoenteric fistula(AEF) which were identified by CTA. The follow-up of CDU showed that the extra-anatomic bypasses remained their patency in 5 cases, 1 case occurred bypass occlusion. The range of infectious area and bubbles reduced in 2 cases. There was no change of endoleak in 1 case. All the follow-up results were consistent with those of CTA. Conclusion: CDU can comprehensively evaluate the infection in and around the aneurysm in patients with stentinfection after EVAR, with a high auuraly, and has important clinical significance for the early diagnosis, treatment and prognosis of patients.