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Verlaufskontrolle nach endovaskulärer Therapie des infrarenalen Aortenaneurysmas

Kontrastmittelverstärkte Sonographie als Alternative zur CT-Angiographie

Follow-up control after endovascular treatment of infrarenal aortic aneurysms

Contrast-enhanced sonography as alternative to CT angiography

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Zusammenfassung

Die endovaskuläre Behandlung infrarenaler Aortenaneurysmen (EVAR) hat sich bei geeigneter Aortenkonfiguration als effiziente und gering invasive Therapieoption etabliert. Persistierende oder neu aufgetretene Endoleckagen können allerdings im weiteren Verlauf Ursache und Indikation sekundärer Reinterventionen oder auch sekundärer Aneurysmarupturen sein und erfordern deshalb lebenslange Kontrolluntersuchungen. Wir haben die kontrastverstärkte Sonographie (CEUS) als mögliches Diagnoseverfahren zur Langzeitverlaufsdiagnostik evaluiert. Die Befunde zeigen, dass die kontrastverstärkte Sonographie bei Patienten nach endovaskulärer Ausschaltung infrarenaler Aneurysmen eine geeignete Alternative zur CT-Angiographie darstellt, mit der Möglichkeit, die Applikation von jodhaltigem Kontrastmittel und die Strahlenexposition zu reduzieren und zusätzlicher Anwendungsoption bei Patienten mit eingeschränkter Nierenfunktion oder vermuteter Allergie auf jodhaltige Kontrastmittel.

Abstract

Endovascular aortic repair (EVAR) has become accepted as an efficient and minimally invasive therapeutic option for patients with infrarenal aortic aneurysms. However, persisting or newly developed endoleaks can cause indications for secondary reinterventions or result in secondary aortic rupture, demanding life-long surveillance. We have, therefore, evaluated contrast-enhanced ultrasonography (CEUS) as a possible diagnostic tool for long-term control examinations. Our results indicate that CEUS is a valuable diagnostic option for follow-up of patients with endovascular aortic repair of infrarenal aneurysms, with the possibility of reduction in iodine-containing contrast media and time of radiation exposure and is a diagnostic option even in patients with impaired renal function or a history of allergic reactions after exposure to iodine-containing contrast media.

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Authors and Affiliations

  1. Chirurgische Klinikum, Klinikum Großhadern, LMU München, München, Deutschland

    R. Kopp, G. Meimarakis & R. Weidenhagen

  2. Institut für Klinische Radiologie, Klinikum Großhadern, LMU München, München, Deutschland

    S. Weckbach, N. Minaifar & DA Clevert

Authors
  1. R. Kopp
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  2. S. Weckbach
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  3. N. Minaifar
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  4. G. Meimarakis
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  5. R. Weidenhagen
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  6. DA Clevert
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Correspondence to R. Kopp.

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Kopp, R., Weckbach, S., Minaifar, N. et al. Verlaufskontrolle nach endovaskulärer Therapie des infrarenalen Aortenaneurysmas. Gefässchirurgie 13, 410–416 (2008). https://doi.org/10.1007/s00772-008-0638-0

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  • DOI: https://doi.org/10.1007/s00772-008-0638-0

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