Document Detail


Pre-discharge duplex ultrasound scans detect endoleaks not seen on completion angiography after endovascular aneurysm repair.
MedLine Citation:
PMID:  20557174     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine whether a pre-discharge duplex ultrasound scan detects early endoleaks that would not otherwise have been identified. METHODS: A retrospective review was conducted of all patients undergoing elective infrarenal endovascular aneurysm repair (EVAR) at our center. These patients underwent intraoperative completion angiography, had a duplex ultrasound scan prior to hospital discharge, and were followed at 1, 3, and 6 months and at 6-month intervals thereafter. The outcome of any patients found to have an endoleak on a pre-discharge scan was studied. RESULTS: There were 52 EVAR patients (50 men; mean age 76 years, range 61-87) with endoleak on the pre-discharge duplex: 17 (2.8%) type I, 28 (4.6%) type II, and 8 (1.3%) type III. Of these, only 7 of the type I and 2 of the type II leaks had been detected on completion angiography. Among the patients with type I endoleaks, 5 had resolution of the leak, 10 required further endovascular interventions, and 2 had open repair (1 died of aneurysm rupture). Two patients with failed endovascular repairs of the leak also had open repair. Fifteen of the 28 type II endoleaks resolved, 4 were treated with endovascular procedures, 1 had open repair, 7 are being observed, and 1 was lost to follow-up. Six of the 8 type III leaks resolved, 1 required open repair for an enlarging sac, and 1 is being observed. CONCLUSION: Despite routine completion angiography, new endoleaks may be identified postoperatively, which suggests that more rigorous imaging at the point of completion angiography is required.
Authors:
Rebecca M Sandford; Andrew J Batchelder; Matthew J Bown; Robert D Sayers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-18     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  349-53     Citation Subset:  IM    
Affiliation:
Vascular Surgery Group, Department of Cardiovascular Sciences, University of Leicester, UK. bex125@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aortic Aneurysm / mortality,  radiography,  surgery*,  ultrasonography*
Aortography / methods*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
England
Female
Humans
Male
Middle Aged
Patient Discharge
Predictive Value of Tests
Prosthesis Failure*
Reoperation
Retrospective Studies
Stents*
Surgical Procedures, Elective
Time Factors
Tomography, X-Ray Computed*
Treatment Outcome
Ultrasonography, Doppler, Color*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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