Study of endoleaks after endovascular repair by using MDCTA

L. Saba 1, R. Sanfilippo 3, L. Pascalis 4, R. Montisci 3, G. Mallarini 1,2

1 Department of Science of the Images, A.O.U. di Cagliari, Cagliari (Italy) 2 Institute of Radiology, University of Cagliari, Cagliari (Italy) 3 Department of Vascular Surgery, A.O.U. di Cagliari, Cagliari (Italy) 4 Department of Internal Medicine, A.O.U. di Cagliari, Cagliari (Italy)

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• Angiology
• Radiology

Abstract. – Purpose: Our purpose was to investigate the multi-detector-row CT angiography (MDCTA) application in endoleak detection.
Methods: Fifty-nine patients that underwent endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm with endoluminal stent graft were retrospectively studied. MDCTA scans were obtained after administration of 110-130 mL of contrast material using a 4-6 mL/sec flow rate. We made unenhanced, arterial (15-20 sec) and delayed (100 sec) acquisitions. For each patient four MDCTA datasets (pre-EVAR, 1, 6, and 12 months follow-up) were obtained. Each examination was studied by two observers. Kappa value was calculated in order to evaluate inter-observer agreement.
Results: Twenty-one endoleaks were detected in eighteen patients. Fifteen and eighteen endoleaks were detected by using biphasic arterial CT and biphasic delayed CT respectively (sensitivity of 71.4% and 85.7% respectively). We observed a positive correlation between the presence of endoleak and the increasement in aneurysm size. Interobserver agreement was 88.1% and kappa value was 0.685.
Conclusions: Biphasic CT for endoleak detection is significantly superior to arterial and delayed phases respectively. We observed a good interobserver agreement.

Corresponding Author: Luca Saba MD; e-mail: lucasaba@tiscali.it

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