Background: Reducing fluoroscopy times and iodine contrast administration during endovascular repair (EVAR) of infrarenal aortic aneurysms remains a challenge. The purpose of this study is to evaluate the preliminary results of a fully ultrasound-assisted EVAR without iodine contrast administration. Methods: Twenty-seven consecutive patients underwent an elective intravascular ultrasound (IVUS)eassisted EVAR with final contrast-enhanced ultrasound (CEUS) control of correct aneurysm exclusion. In no case intraprocedural injection of iodine contrast medium was performed. The primary study’s end points were the overall duration of the procedure, duration of fluoroscopy, cumulative radiation dose, the length of intraoperative CEUS control, and the comparison of findings between intraoperative CEUS and computed tomography (CT) scan at 1 month. Results: Mean duration of the procedure was 130 ± 35 min. Overall duration of fluoroscopy was 22 ± 18 min. Mean radiation dose was 66 mGy (range 24e82). The mean length of CEUS final control was 8 ± 2 min. No type I or type III endoleak was detected either at CEUS or at angio-CT scan at 1 month from EVAR. CEUS revealed a type II endoleak in 6 patients (22%), compared to 9 type II endoleaks (33%) detected at angio-CT scan 1 month after the procedure (P ¼ 0.5). Conclusions: Fully ultrasound (IVUS and CEUS)eassisted EVAR is safe, feasible, and reliable, completely eliminating the need for iodine contrast medium and reducing the radiation exposure for both patients and surgeons.

Fully ultrasound-assisted endovascular aneurysm repair: preliminary report / Illuminati, Giulio; Nardi, Priscilla; Fresilli, Daniele; Sorrenti, Salvatore; Lauro, Augusto; Pizzardi, Giulia; Ruggeri, Massimo; Ulisse, Salvatore; Cantisani, Vito; D'Andrea, Vito. - In: ANNALS OF VASCULAR SURGERY. - ISSN 1615-5947. - (2022), pp. 1-6. [10.1016/j.avsg.2022.02.016]

Fully ultrasound-assisted endovascular aneurysm repair: preliminary report

Giulio Illuminati
Primo
;
Priscilla Nardi
Secondo
;
Daniele Fresilli;Salvatore Sorrenti;Augusto Lauro;Salvatore Ulisse;Vito Cantisani
Penultimo
;
Vito D'Andrea
Ultimo
2022

Abstract

Background: Reducing fluoroscopy times and iodine contrast administration during endovascular repair (EVAR) of infrarenal aortic aneurysms remains a challenge. The purpose of this study is to evaluate the preliminary results of a fully ultrasound-assisted EVAR without iodine contrast administration. Methods: Twenty-seven consecutive patients underwent an elective intravascular ultrasound (IVUS)eassisted EVAR with final contrast-enhanced ultrasound (CEUS) control of correct aneurysm exclusion. In no case intraprocedural injection of iodine contrast medium was performed. The primary study’s end points were the overall duration of the procedure, duration of fluoroscopy, cumulative radiation dose, the length of intraoperative CEUS control, and the comparison of findings between intraoperative CEUS and computed tomography (CT) scan at 1 month. Results: Mean duration of the procedure was 130 ± 35 min. Overall duration of fluoroscopy was 22 ± 18 min. Mean radiation dose was 66 mGy (range 24e82). The mean length of CEUS final control was 8 ± 2 min. No type I or type III endoleak was detected either at CEUS or at angio-CT scan at 1 month from EVAR. CEUS revealed a type II endoleak in 6 patients (22%), compared to 9 type II endoleaks (33%) detected at angio-CT scan 1 month after the procedure (P ¼ 0.5). Conclusions: Fully ultrasound (IVUS and CEUS)eassisted EVAR is safe, feasible, and reliable, completely eliminating the need for iodine contrast medium and reducing the radiation exposure for both patients and surgeons.
2022
Infrarenal aortic aneurysms; EVAR, CEUS
01 Pubblicazione su rivista::01a Articolo in rivista
Fully ultrasound-assisted endovascular aneurysm repair: preliminary report / Illuminati, Giulio; Nardi, Priscilla; Fresilli, Daniele; Sorrenti, Salvatore; Lauro, Augusto; Pizzardi, Giulia; Ruggeri, Massimo; Ulisse, Salvatore; Cantisani, Vito; D'Andrea, Vito. - In: ANNALS OF VASCULAR SURGERY. - ISSN 1615-5947. - (2022), pp. 1-6. [10.1016/j.avsg.2022.02.016]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1626907
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