Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance.

摘要: Endovascular aneurysm repair (EVAR) represents one of the greatest advances in vascular surgery over past 50 years. In contrast to conventional repair, EVAR requires accurate preoperative imaging and stringent postoperative surveillance. Duplex ultrasound (DUS), transesophageal echocardiography, intravascular ultrasound, computed tomography (CT) magnetic resonance (MR), each provide useful information for patient selection, choice endograft type Today most interventionists surgeons will rely on CT or MR assess aortic morphology, evaluate access artery patency locate side branch orifices. However, recent developments cross-sectional imaging, including advanced image postprocessing, multi-modality fusion new agents have resulted improved spatial resolution planning. Advanced reconstruction algorithms, like dynamic CTA MRA, valuable changes morphology that might an important impact selection. During follow-up, graft is utmost importance identify patients need secondary intervention. This has led rigorous follow-up protocols duplex regular examinations. The use these intense recently been questioned because high radiation dose frequent nephrotoxic agents. New modalities enhanced DUS, dual-source could reduce obviate contrast. Up-to-date knowledge non-invasive processing crucial planning essential development programs involving reduced risk harmful effects.