Abstract
Objective.As aneurysm related events and rupture is not eliminated,
postoperative lifelong surveillance is mandatory after endovascular
aneurysm repair(EVAR).For surveillance colored Doppler ultrasound(CDUS)
is a standard method of noninvasive evaluation having the advantages of
availability, cost-effectiveness and lack of nephrotoxicity and
radiation.We evaluated CDUS for primary surveillance tool after elective
EVAR by comparing with computerized tomography. Methods.Between
2018-2020, 84 consecutive post-EVAR patients were evaluated.Firstly,
CDUS was performed by two Doppler operators from the Radiology and
computed tomographic angiography (CTA) was performed.A reporting
protocol was organized for endoleak detection and largest aneurysm
diameter. Results.Among 84 patients, there were 11 detected
endoleaks(13,1%) with CTA and 7 of them was detected with CDUS
(r=0,884,p<0.001).There is an insufficiency in detecting low
flow by CDUS.Eliminating this frailty, there was a strong correlation of
aneurysm sac diameter measurement between CTA and CDUS
(r=0,777,p<0,001).The sensitivity and specificity of CDUS was
63,6% and 100% respectively.The accuracy was 95,2%.Positive and
negative predictive values were 100% and 94,8%.Bland-Altman analysis
and linear regression analysis showed no proportional bias (mean
difference of 1.5±2.2mm,p=0.233). Conclusions.CDUS promises accurate
results without missing any potential complication requiring
intervention as Type I or III endoleak.Lack of detecting type II
endoleaks may be negligible as sac enlargement was the key for
reintervention in this situation and CDUS has a remarkably high
correlation with CTA in sac diameter measurement. CDUS may be a primary
surveillance tool for EVAR and CTA will be reserved in case of aneurysm
sac enlargement,detection of an endoleak,inadequate CDUS or in case of
unexplained abdominal symptomatology