Vinicio Napoli MD, Presenter: Nothing to Disclose

Irene Bargellini MD, Abstract Co-Author: Nothing to Disclose

Pasquale Petruzzi, Abstract Co-Author: Nothing to Disclose

Roberto Cioni, Abstract Co-Author: Nothing to Disclose

Mauro Ferrari MD, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

To evaluate the dynamic features of type II lumbar endoleaks (EL) on contrast-enhanced sonography (CUS) and their influence on aneurysm (AAA) enlargement after endovascular repair.

The study included 18 male patients (mean age 71.8±7.8 years) with type II lumbar EL confirmed at DSA. All patients underwent CTA follow-up. On CTA, AAA volumes were calculated, and EL detection, volume and extension were assessed. CUS was performed by a blinded radiologist assessing: presence of contrast within the aneurysmal sac (EL), delay of EL detection from the beginning of contrast injection (wash-in), delay of contrast disappearance (wash-out), visualization of inflow and outflow vessels, presence of cavity filling (contrast concentration within a pseudocavity). Correlation between AAA enlargement and EL features was assessed.

All patients showed an EL at CUS. Median wash-in and wash-out times were 84 and 320.5 sec, respectively; a significant correlation was observed between these two parameters (p1 mm3/month (eight patients, 44.4%) was significantly associated with the hypodynamic EL (particularly the wash-out time). Using the above-mentioned referral values, sensitivity, specificity, PPV, NPV and accuracy in identifying enlarging AAA were 62.5%, 100%, 100%, 76.9% and 83.3% for wash-out time, and 75%, 80%, 75%, 80% and 77.7% for wash-in. Moreover, AAA enlargement was not associated with volume and extension of EL calculated at CTA.

Although larger series are required, type II lumbar EL show different hemodynamic features at CUS, that might influence rate of aneurysm enlargement addressing the need for treatment.

Napoli, V, Bargellini, I, Petruzzi, P, Cioni, R, Ferrari, M, Bartolozzi, C, Contrast-enhanced Sonography: Hemodynamic Differentiation of Type II Lumbar Endoleaks and Influence on Aneurysm Enlargement after EVAR.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415580.html