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- W1598064462 abstract "The introduction of endovascular stent-graft repair for aortic aneurysm has engendered considerable enthusiasm and interest from vascular specialist. With progressive improvement in imaging, clinical experience, and stent-graft design, and the use of adjuvant procedures, a substantial number of patients are now candidates for endovascular repair of an aortic aneurysm. Endoluminal aneurysm repair, however, currently is at a critical point. Unquestionably, endoluminal aneurysm repair can reduce substantially the need for intensive care and length of hospital stay, and survival is reportedly improved when compared with open repair. Although the use of stent-grafts for the treatment of thoracic and abdominal aneurysms has increased dramatically there is little midterm or long-term proof of its efficacy. Endovascular aortic aneurysm repair (EVAR trial participants, 2005) has an initial postoperative benefit versus open AAA repair as a result of decreased early morbidity and mortality (EVAR trial participants. 2005; Lederle et al., 2007). However, as shown in EVAR trial 1 (EVAR trial participants, 2005), stent-graft-related complications are observed in approximately 40% of patients within 4 years after EVAR, resulting in a 20% reintervention rate to reduce the ongoing rupture risk. Persistent blood flow into the aneurysm sac and outside the graft lumen (endoleak) represents the most frequent complication after EVAR and is considered a procedural failure, since it is associated with aneurysm enlargement and possible rupture. The reported incidence of endoleaks ranges from 10% to 45%, and lifelong surveillance is required for early detection and treatment. As with the entire field of endovascular surgery, imaging techniques and recommendations regarding their use are changing rapidly. Only long-term follow-up data determine which methods will become standard. Currently, the imaging modalities best suited to achieve the above goals are plain film radiographs of the abdomen (chest) and CT angiography with specialized 3D reconstruction protocols (Fig. 1). In centers of excellence, color or powerDoppler ultrasound is a useful adjunctive modality and ultimately may decrease the required frequency of more expensive studies such as CT. The modalities for postoperative imaging of endoleak may be surrogate or direct (May et al., 2005). The surrogate modalities include plain abdominal x-ray and measurement of AAA diameter by B-mode ultrasound or CT. Because the majority of endografts have a radio-opaque metallic frame, a plain abdominal x-ray is a useful investigation (Fig. 2). It may demonstrate faulty fixation more" @default.
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- W1598064462 date "2011-06-22" @default.
- W1598064462 modified "2023-09-23" @default.
- W1598064462 title "Color-Doppler Ultrasonography in the Monitoring of Endovascular Abdominal Aortic Aneurysm Repair" @default.
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- W1598064462 doi "https://doi.org/10.5772/18593" @default.
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