Use of Contrast-Enhanced Ultrasound for the Diagnosis of Endoleak After EVAR: A Case Report

Introduction

Abdominal aortic aneurysm (AAA), with an estimated prevalence of 4–8% and a higher incidence in men, older people, hypertensive patients, and smokers, can be treated with surgical or endovascular aneurysm repair (EVAR). When well-indicated, EVAR is primarily used since it is less invasive and has lower morbidity and mortality rates. However, due to possible complications, routine clinical and imaging surveillance is necessary to identify or prevent periprosthetic leaks (endoleaks) associated with aneurysmal disease progression.

Accordingly, computed tomography angiography (CTA) has always been considered the gold standard for endoleak surveillance due to its high image quality and usefulness for two- and three-dimensional reconstruction; however, its use of iodinated contrast and exposure to ionizing radiation are disadvantages. Therefore, other post-EVAR control imaging methods such as contrast-enhanced ultrasound (CEUS) have been studied as an endoleak dynamic and high-quality assessment method.^,

[…]