Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up.
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Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up. / Bley, Thorsten; Chase, Peter J; Reeder, Scott B; François, Christopher J; Shinki, Kazuhiko; Tefera, Girma; Ranallo, Frank N; Grist, Thomas M; Pozniak, Myron.
In: RADIOLOGY, Vol. 253, No. 1, 1, 2009, p. 253-262.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Endovascular abdominal aortic aneurysm repair: nonenhanced volumetric CT for follow-up.
AU - Bley, Thorsten
AU - Chase, Peter J
AU - Reeder, Scott B
AU - François, Christopher J
AU - Shinki, Kazuhiko
AU - Tefera, Girma
AU - Ranallo, Frank N
AU - Grist, Thomas M
AU - Pozniak, Myron
PY - 2009
Y1 - 2009
N2 - PURPOSE: To evaluate the clinical usefulness of volumetric analysis at nonenhanced computed tomography (CT) as the sole method with which to follow up endovascular abdominal aortic aneurysm repair (EVAR) and to identify endoleaks causing more than 2% volumetric increase from the previous volume determination. MATERIALS AND METHODS: The study had institutional review board approval. Images were reviewed retrospectively in a HIPAA-compliant manner for 230 CT studies in 70 patients (11 women, 59 men; mean age, 74 years) who underwent EVAR. The scannning protocol consisted of three steps: (a) contrast material-enhanced CT angiography before endovascular stent placement, (b) contrast-enhanced CT angiography 0-3 months after repair to depict immediate complications, and (c) nonenhanced CT at 3, 6, and 12 months after repair. At each follow-up visit, immediate aortic volume analysis was performed. If the interval volumetric change was 2% or less, no further imaging was performed. If the volume increased by more than 2% on the nonenhanced CT image, contrast-enhanced CT angiography was performed immediately to identify the suspected endoleak. Confidence intervals (CIs) were obtained by using bootstrapping to account for repeated measurements in the same patients. RESULTS: Mean volume decrease was -3.2% (95% CI: -4.7%, -1.9%) in intervals without occurrence of a clinically relevant endoleak (n = 183). Types I and III high-pressure endoleaks (n = 10) showed a 10.0% (95% CI: 5.0%, 18.2%) interval volumetric increase. Type II low-pressure endoleaks (n = 37) showed a 5.4% (95% CI: 4.6%, 6.2%) interval volumetric increase. Endoleaks associated with minimal aortic volume increase of less than 2% did not require any intervention. This protocol reduced radiation exposure by approximately 57%-82% in an average-sized patient. CONCLUSION: Serial volumetric analysis of aortic aneurysm with nonenhanced CT serves as an adequate screening test for endoleak, causing volumetric increase of more than 2% from the volume seen at the previous examination.
AB - PURPOSE: To evaluate the clinical usefulness of volumetric analysis at nonenhanced computed tomography (CT) as the sole method with which to follow up endovascular abdominal aortic aneurysm repair (EVAR) and to identify endoleaks causing more than 2% volumetric increase from the previous volume determination. MATERIALS AND METHODS: The study had institutional review board approval. Images were reviewed retrospectively in a HIPAA-compliant manner for 230 CT studies in 70 patients (11 women, 59 men; mean age, 74 years) who underwent EVAR. The scannning protocol consisted of three steps: (a) contrast material-enhanced CT angiography before endovascular stent placement, (b) contrast-enhanced CT angiography 0-3 months after repair to depict immediate complications, and (c) nonenhanced CT at 3, 6, and 12 months after repair. At each follow-up visit, immediate aortic volume analysis was performed. If the interval volumetric change was 2% or less, no further imaging was performed. If the volume increased by more than 2% on the nonenhanced CT image, contrast-enhanced CT angiography was performed immediately to identify the suspected endoleak. Confidence intervals (CIs) were obtained by using bootstrapping to account for repeated measurements in the same patients. RESULTS: Mean volume decrease was -3.2% (95% CI: -4.7%, -1.9%) in intervals without occurrence of a clinically relevant endoleak (n = 183). Types I and III high-pressure endoleaks (n = 10) showed a 10.0% (95% CI: 5.0%, 18.2%) interval volumetric increase. Type II low-pressure endoleaks (n = 37) showed a 5.4% (95% CI: 4.6%, 6.2%) interval volumetric increase. Endoleaks associated with minimal aortic volume increase of less than 2% did not require any intervention. This protocol reduced radiation exposure by approximately 57%-82% in an average-sized patient. CONCLUSION: Serial volumetric analysis of aortic aneurysm with nonenhanced CT serves as an adequate screening test for endoleak, causing volumetric increase of more than 2% from the volume seen at the previous examination.
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Treatment Outcome
KW - Follow-Up Studies
KW - Contrast Media
KW - Aortic Aneurysm, Abdominal radiography
KW - Cone-Beam Computed Tomography methods
KW - ROC Curve
KW - Retrospective Studies
KW - Stents
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Treatment Outcome
KW - Follow-Up Studies
KW - Contrast Media
KW - Aortic Aneurysm, Abdominal radiography
KW - Cone-Beam Computed Tomography methods
KW - ROC Curve
KW - Retrospective Studies
KW - Stents
M3 - SCORING: Zeitschriftenaufsatz
VL - 253
SP - 253
EP - 262
JO - RADIOLOGY
JF - RADIOLOGY
SN - 0033-8419
IS - 1
M1 - 1
ER -
