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Comparison of Doppler ultrasonography and computed tomography angiography for endoleak diagnosis after endovascular treatment of abdominal aortic aneurysm

Uğur Demir¹, Mehmet Şenel Bademci², Tevfik Güneş³, Hasan İner⁴, Ali Gürbüz⁴, Muhsin Engin Uluç<sup>5

1</sup>Department of Radiology, Health Sciences University, Başakşehir Cam and Sakura City Hospital, Istanbul, Turkey
²Department of Cardiovascular Surgery, Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
³Department of Cardiovascular Surgery, Akut Cardiac and Vascular Hospital, Izmir, Turkey
⁴Department of Cardiovascular Surgery, Izmir Katip Çelebi University, Faculty of Medicine, Izmir, Turkey
⁵Department of Radiology, Izmir Katip Çelebi University, Faculty of Medicine, Izmir, Turkey

Keywords: Aneurysm, computed tomography angiography, Doppler ultrasound, endoleaks, endovascular aneurysm repair

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Objectives: This study aims to compare the utility of Doppler ultrasound (DUS) versus computed tomography angiography (CTA) in the diagnosis of endoleaks.

Patients and methods: Between October 2008 and December 2010, a total of 30 patients (27 males, 3 females; mean age: 70.1±12 years, range: 52 to 85 years) with abdominal aortic aneurysms (AAAs) who underwent endovascular aneurysm repair (EVAR) were retrospectively analyzed. All patients were followed at 1, 6, and 12 months after EVAR with both DUS and CTA.

Results: Stents grafts were patent in all patients. Endoleak was detected with CTA in six patients. Four patients had type I endoleak and two had type 2 endoleak. On CTA, two patients with type 2 endoleaks were unable to be detected with DUS. Considering CTA as the gold standard, DUS had a sensitivity and specificity of 75% and 100%, respectively. For detecting type 1 endoleak, DUS demonstrated a sensitivity and specificity of 100% and 100%, respectively. For detecting type 2 endoleak, DUS had a sensitivity of 50% and specificity of 100%.

Conclusion: Our study results suggest that DUS is reliable method for detecting endoleak and measuring diameter of aneurysm during follow-up after EVAR. It may be possible to use DUS as an alternative to CTA in routine follow-up of the patients.

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