Key result
Contrast-enhanced ultrasound demonstrated a pooled endoleak detection rate of 96.67% compared to 92.82% for computed tomography angiography following endovascular aortic aneurysm repair.
Why the study?
The study aimed to assess the role of Color Duplex Ultrasound with or without contrast media for surveillance following endovascular aortic aneurysm repair.
Does Color Duplex Ultrasound with or without contrast media accurately detect endoleaks compared to Computed Tomography Angiography in patients following endovascular aortic aneurysm repair?
Meta-Analysis (n=5,214)
Does Color Duplex Ultrasound with or without contrast media accurately detect endoleaks compared to Computed Tomography Angiography in patients following endovascular aortic aneurysm repair?
Absolute Event Rate: 96.67% vs 92.82%
Contrast-enhanced ultrasound demonstrates high endoleak detection rates (96.67%) comparable to CTA, supporting its integration into post-EVAR surveillance protocols.
Supports CEUS integration into post-EVAR surveillance; reinforces meta-analytic evidence for its diagnostic role versus CTA.
This study aims to assess the role of Color Duplex Ultrasound with or without contrast media for surveillance following endovascular aortic aneurysm repair (EVAR). A systematic search of the literature published until April 2022 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The pooled rates of endoleak detection through Contrast-Enhanced or Color Duplex Ultrasound (CEUS or CDUS) and Computed Tomography Angiography (CTA) with 95% confidence intervals (CIs) were estimated using random-effect analysis. Thirty-eight studies were considered eligible for inclusion. The total number of patients in the included studies was 5214 between 1997 and 2021. The overall pooled rate of endoleak detection using CDUS and CTA was 82.59% and 97.22%, while the rates for CEUS and CTA were 96.67% and 92.82%, respectively. The findings of the present study support the use of the CEUS for endoleak detection. However, it should be integrated into institutional protocols for EVAR surveillance to further evaluate its clinical utility in the post-EVAR period before it can be recommended as the sole imaging modality after EVAR.
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Karaolanis et al. (2022) conducted a meta-analysis in Endoleak after endovascular abdominal aortic aneurysm repair (n=5,214). Contrast-Enhanced Ultrasound (CEUS) vs. Computed Tomography Angiography (CTA) was evaluated on Endoleak detection. Contrast-enhanced ultrasound demonstrated a pooled endoleak detection rate of 96.67% compared to 92.82% for computed tomography angiography following endovascular aortic aneurysm repair.
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