Duplex Ultrasound Scanning (DUS) Versus Computed Tomography Angiography (CTA) in the Follow-Up After EVAR

Introduction: Computed tomography angiography (CTA) is the gold standard follow-up modality after endovascular aneurysm repair (EVAR). A potential alternative noninvasive and less expensive modality is duplex ultrasound scanning (DUS). Methods: We studied 314 follow-up paired scans (DUS and CTA) in 59 patients with EVAR. Results: Endoleak—Endoleak was detected in 23.7% patients. The sensitivity and specificity rates of DUS were 54% and 95.3%, respectively. All 9 endoleaks that needed secondary intervention were detected on DUS. Eight of those were identified within a year after EVAR. Sac size—The mean difference in maximum diameter between the DUS and CTA was ≤5 mm in 84.5% of cases and ≤10 mm in 97.1%. Graft patency—There was 100% agreement between CTA and DUS. Conclusions: Duplex ultrasound scanning was reliable as it detected all the leaks that needed reintervention after EVAR. Duplex ultrasound scanning showed similar results to CTA in detecting sac size and patency.