Abdominal Radiology

, Volume 43, Issue 5, pp 1044–1066 | Cite as

Abdominal aortic aneurysms: pre- and post-procedural imaging

  • Richard L. Hallett
  • Brant W. Ullery
  • Dominik Fleischmann


Abdominal aortic aneurysm (AAA) is a relatively common, potentially life-threatening disorder. Rupture of AAA is potentially catastrophic with high mortality. Intervention for AAA is indicated when the aneurysm reaches 5.0–5.5 cm or more, when symptomatic, or when increasing in size > 10 mm/year. AAA can be accurately assessed by cross-sectional imaging including computed tomography angiography and magnetic resonance angiography. Current options for intervention in AAA patients include open surgery and endovascular aneurysm repair (EVAR), with EVAR becoming more prevalent over time. Cross-sectional imaging plays a crucial role in AAA surveillance, pre-procedural assessment, and post-EVAR management. This paper will discuss the current role of imaging in the assessment of AAA patients prior to intervention, in evaluation of procedural complications, and in long-term follow-up of EVAR patients.


Aneurysm Aorta Abdominal aorta Endograft Endoleak Aneurysm surveillance 


  1. 1.
    Aggarwal S, Qamar A, Sharma V, Sharma A (2011) Abdominal aortic aneurysm: a comprehensive review. Exp Clin Cardiol 16:11–15PubMedPubMedCentralGoogle Scholar
  2. 2.
    Pearce WH, Zarins CK, Bacharach JM, American Heart Association Writing Group 6 (2008) Atherosclerotic peripheral vascular disease symposium II: controversies in abdominal aortic aneurysm repair. Circulation 118:2860–2863PubMedCrossRefGoogle Scholar
  3. 3.
    Lederle FA, Johnson GR, Wilson SE, et al. (2002) Rupture rate of large abdominal aortic aneurysms in patients refusing or unfit for elective repair. JAMA 287:2968–2972PubMedCrossRefGoogle Scholar
  4. 4.
    Assar AN, Zarins CK (2009) Ruptured abdominal aortic aneurysm: a surgical emergency with many clinical presentations. Postgrad Med J 85:268–273PubMedCrossRefGoogle Scholar
  5. 5.
    Walker TG, Kalva SP, Yeddula K, et al. (2010) Clinical practice guidelines for endovascular abdominal aortic aneurysm repair: written by the Standards of Practice Committee for the Society of Interventional Radiology and endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association. JVIR 21:1632–1655PubMedCrossRefGoogle Scholar
  6. 6.
    Parodi JC, Palmaz JC, Barone HD (1991) Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 5:491–499PubMedCrossRefGoogle Scholar
  7. 7.
    Ng TT, Mirocha J, Magner D, Gewertz BL (2010) Variations in the utilization of endovascular aneurysm repair reflect population risk factors and disease prevalence. J Vasc Surg 51:801.e1–809.e1CrossRefGoogle Scholar
  8. 8.
    Schermerhorn ML, O’Malley AJ, Jhaveri A, et al. (2008) Endovascular vs. open repair of abdominal aortic aneurysms in the Medicare population. N Engl J Med Mass Med Soc 358:464–474CrossRefGoogle Scholar
  9. 9.
    Greenhalgh RM, Brown LC, Kwong GPS, Powell JT, Thompson SG (2004) EVAR trial participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet 364:843–848.
  10. 10.
    Powell JT, Sweeting MJ, Ulug P, et al. (2017) Meta-analysis of individual-patient data from EVAR-1, DREAM, OVER and ACE trials comparing outcomes of endovascular or open repair for abdominal aortic aneurysm over 5 years. Br J Surg 104:166–178PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Prinssen M, Buskens E, de Jong SE, et al. (2007) Cost-effectiveness of conventional and endovascular repair of abdominal aortic aneurysms: results of a randomized trial. J Vasc Surg 46:883–890PubMedCrossRefGoogle Scholar
  12. 12.
    United Kingdom EVAR Trial Investigators, Greenhalgh RM, Brown LC, et al. (2010) Endovascular versus open repair of abdominal aortic aneurysm. N Engl J Med 362:1863–1871CrossRefGoogle Scholar
  13. 13.
    White GH, Yu W, May J (1996) Endoleak: a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft. J Endovasc Surg 3:124–125PubMedCrossRefGoogle Scholar
  14. 14.
    Fontaine V, Jacob M-P, Houard X, et al. (2002) Involvement of the mural thrombus as a site of protease release and activation in human aortic aneurysms. Am J Pathol 161:1701–1710PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Di Martino ES, Vorp DA (2003) Effect of variation in intraluminal thrombus constitutive properties on abdominal aortic aneurysm wall stress. Ann Biomed Eng 31:804–809PubMedCrossRefGoogle Scholar
  16. 16.
    Picel AC, Kansal N (2014) Essentials of endovascular abdominal aortic aneurysm repair imaging: postprocedure surveillance and complications. Am J Roentgenol 203:W358–W372CrossRefGoogle Scholar
  17. 17.
    Brown LC, Greenhalgh RM, Powell JT, Thompson SG (2010) EVAR trial participants. Use of baseline factors to predict complications and reinterventions after endovascular repair of abdominal aortic aneurysm. Br J Surg 97:1207–1217PubMedCrossRefGoogle Scholar
  18. 18.
    Iezzi R, Cotroneo AR (2006) Endovascular repair of abdominal aortic aneurysms: CTA evaluation of contraindications. Abdom Imaging 31:722–731PubMedCrossRefGoogle Scholar
  19. 19.
    Truijers M, Resch T, Van Den Berg JC, Blankensteijn JD, Lönn L (2009) Endovascular aneurysm repair: state-of-art imaging techniques for preoperative planning and surveillance. J Cardiovasc Surg 50:423–438Google Scholar
  20. 20.
    van Keulen JW, van Prehn J, Prokop M, Moll FL, van Herwaarden JA (2009) Potential value of aneurysm sac volume measurements in addition to diameter measurements after endovascular aneurysm repair. J Endovasc Ther 16:506–513PubMedCrossRefGoogle Scholar
  21. 21.
    Prinssen M, Verhoeven ELG, Verhagen HJM, Blankensteijn JD (2003) Decision-making in follow-up after endovascular aneurysm repair based on diameter and volume measurements: a blinded comparison. Eur J Vasc Endovasc Surg 26:184–187PubMedCrossRefGoogle Scholar
  22. 22.
    Karmacharya J, Parmer SS, Antezana JN, et al. (2006) Outcomes of accessory renal artery occlusion during endovascular aneurysm repair. J Vasc Surg 43:8–13PubMedCrossRefGoogle Scholar
  23. 23.
    Picel AC, Kansal N (2014) Essentials of endovascular abdominal aortic aneurysm repair imaging: preprocedural assessment. Am J Roentgenol 203:W347–W357CrossRefGoogle Scholar
  24. 24.
    Bastos Gonçalves F, Verhagen HJM, Chinsakchai K, et al. (2012) The influence of neck thrombus on clinical outcome and aneurysm morphology after endovascular aneurysm repair. J Vasc Surg 56:36–44PubMedCrossRefGoogle Scholar
  25. 25.
    Ishibashi H, Ishiguchi T, Ohta T, et al. (2012) Remodeling of proximal neck angulation after endovascular aneurysm repair. J Vasc Surg 56:1201–1205PubMedCrossRefGoogle Scholar
  26. 26.
    Robbins M, Kritpracha B, Beebe HG, et al. (2005) Suprarenal endograft fixation avoids adverse outcomes associated with aortic neck angulation. Ann Vasc Surg 19:172–177PubMedCrossRefGoogle Scholar
  27. 27.
    Donas KP, Torsello G, Bisdas T, et al. (2012) Early outcomes for fenestrated and chimney endografts in the treatment of pararenal aortic pathologies are not significantly different: a systematic review with pooled data analysis. J Endovasc Ther 19:723–728PubMedCrossRefGoogle Scholar
  28. 28.
    Lindblad B, Bin Jabr A, Holst J, Malina M (2015) Chimney grafts in aortic stent grafting: hazardous or useful technique? Systematic review of current data. Eur J Vasc Endovasc Surg 50:722–731PubMedCrossRefGoogle Scholar
  29. 29.
    Linsen MAM, Jongkind V, Nio D, Hoksbergen AWJ, Wisselink W (2012) Pararenal aortic aneurysm repair using fenestrated endografts. J Vasc Surg 56:238–246PubMedCrossRefGoogle Scholar
  30. 30.
    Agag G, Salomon du Mont L, Leclerc B, Behr J, Rinckenbach S (2017) Is suprarenal fixation of aortic stent grafts really without consequence on the renal function? Ann Vasc Surg 39:90–98PubMedCrossRefGoogle Scholar
  31. 31.
    Gawenda M, Brunkwall J (2008) Renal response to open and endovascular repair of abdominal aortic aneurysm: a prospective study. Ann Vasc Surg 22:1–4PubMedCrossRefGoogle Scholar
  32. 32.
    Saratzis A, Sarafidis P, Melas N, Khaira H (2014) Comparison of the impact of open and endovascular abdominal aortic aneurysm repair on renal function. J Vasc Surg 60:597–603PubMedCrossRefGoogle Scholar
  33. 33.
    Walsh SR, Boyle JR, Lynch AG, et al. (2008) Suprarenal endograft fixation and medium-term renal function: systematic review and meta-analysis. J Vasc Surg 47:1364–1370PubMedCrossRefGoogle Scholar
  34. 34.
    Alsac J-M, Zarins CK, Heikkinen MA, et al. (2005) The impact of aortic endografts on renal function. J Vasc Surg 41:926–930PubMedCrossRefGoogle Scholar
  35. 35.
    Lau LL, Hakaim AG, Oldenburg WA, et al. (2003) Effect of suprarenal versus infrarenal aortic endograft fixation on renal function and renal artery patency: a comparative study with intermediate follow-up. J Vasc Surg 37:1162–1168PubMedCrossRefGoogle Scholar
  36. 36.
    Parmer SS, Carpenter JP (2006) Endologix Investigators. Endovascular aneurysm repair with suprarenal vs infrarenal fixation: a study of renal effects. J Vasc Surg 43:19–25PubMedCrossRefGoogle Scholar
  37. 37.
    Cayne NS, Rhee SJ, Veith FJ, et al. (2003) Does transrenal fixation of aortic endografts impair renal function? J Vasc Surg 38:639–644PubMedCrossRefGoogle Scholar
  38. 38.
    Chaikof EL, Fillinger MF, Matsumura JS, et al. (2002) Identifying and grading factors that modify the outcome of endovascular aortic aneurysm repair. J Vasc Surg 35:1061–1066PubMedCrossRefGoogle Scholar
  39. 39.
    Choi HR, Park KH, Lee JH (2016) Risk factor analysis for buttock claudication after internal iliac artery embolization with endovascular aortic aneurysm repair. Vasc Specialist Int 32:44–50PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Chun J-Y, Mailli L, Abbasi MA, et al. (2014) Embolization of the internal iliac artery before EVAR: is it effective? Is it safe? Which technique should be used? Cardiovasc Interv Radiol 37:329–336CrossRefGoogle Scholar
  41. 41.
    Naughton PA, Park MS, Kheirelseid EAH, et al. (2012) A comparative study of the bell-bottom technique vs hypogastric exclusion for the treatment of aneurysmal extension to the iliac bifurcation. J Vasc Surg 55:956–962PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Ferreira M, Monteiro M, Lanziotti L (2010) Technical aspects and midterm patency of iliac branched devices. J Vasc Surg 51:545–550 (Discussion 550)PubMedCrossRefGoogle Scholar
  43. 43.
    Manunga JM, Gloviczki P, Oderich GS, et al. (2013) Femoral artery calcification as a determinant of success for percutaneous access for endovascular abdominal aortic aneurysm repair. J Vasc Surg 58:1208–1212PubMedCrossRefGoogle Scholar
  44. 44.
    Gupta V, Feng K, Cheruvu P, et al. (2014) High femoral artery bifurcation predicts contralateral high bifurcation: implications for complex percutaneous cardiovascular procedures requiring large caliber and/or dual access. J Invasive Cardiol 26:409–412PubMedGoogle Scholar
  45. 45.
    Early H, Atkins M (2012) Technical tips for managing difficult iliac access. Semin Vasc Surg 25:138–143PubMedCrossRefGoogle Scholar
  46. 46.
    Maldonado TS, Rockman CB, Riles E, et al. (2004) Ischemic complications after endovascular abdominal aortic aneurysm repair. J Vasc Surg 40:703–710 (Discussion 709)PubMedCrossRefGoogle Scholar
  47. 47.
    Hodgson R, McWilliams RG, Simpson A, et al. (2003) Migration versus apparent migration: importance of errors due to positioning variation in plain radiographic follow-up of aortic stent-grafts. J Endovasc Ther 10:902–910PubMedCrossRefGoogle Scholar
  48. 48.
    Fearn S, Lawrence-Brown MMD, Semmens JB, Hartley D (2003) Follow-up after endovascular aortic aneurysm repair: the plain radiograph has an essential role in surveillance. J Endovasc Ther 10:894–901PubMedCrossRefGoogle Scholar
  49. 49.
    Harrison GJ, Oshin OA, Vallabhaneni SR, et al. (2011) Surveillance after EVAR based on duplex ultrasound and abdominal radiography. Eur J Vasc Endovasc Surg 42:187–192PubMedCrossRefGoogle Scholar
  50. 50.
    Kranokpiraksa P, Kaufman JA (2008) Follow-up of endovascular aneurysm repair: plain radiography, ultrasound, CT/CT angiography, MR imaging/MR angiography, or what? JVIR 19:S27–S36PubMedCrossRefGoogle Scholar
  51. 51.
  52. 52.
    Wolf YG, Johnson BL, Hill BB, et al. (2000) Duplex ultrasound scanning versus computed tomographic angiography for postoperative evaluation of endovascular abdominal aortic aneurysm repair. J Vasc Surg 32:1142–1148PubMedCrossRefGoogle Scholar
  53. 53.
    Sprouse LR, Meier GH, Parent FN, et al. (2004) Is ultrasound more accurate than axial computed tomography for determination of maximal abdominal aortic aneurysm diameter? Eur J Vasc Endovasc Surg 28:28–35PubMedCrossRefGoogle Scholar
  54. 54.
    Beeman BR, Doctor LM, Doerr K, et al. (2009) Duplex ultrasound imaging alone is sufficient for midterm endovascular aneurysm repair surveillance: a cost analysis study and prospective comparison with computed tomography scan. J Vasc Surg 50:1019–1024PubMedCrossRefGoogle Scholar
  55. 55.
    Raman KG, Missig-Carroll N, Richardson T, Muluk SC, Makaroun MS (2003) Color-flow duplex ultrasound scan versus computed tomographic scan in the surveillance of endovascular aneurysm repair. J Vasc Surg 38:645–651PubMedCrossRefGoogle Scholar
  56. 56.
    Sato DT, Goff CD, Gregory RT, et al. (1998) Endoleak after aortic stent graft repair: diagnosis by color duplex ultrasound scan versus computed tomography scan. J Vasc Surg 28:657–663PubMedCrossRefGoogle Scholar
  57. 57.
    Arko FR, Filis KA, Siedel SA, et al. (2003) Intrasac flow velocities predict sealing of type II endoleaks after endovascular abdominal aortic aneurysm repair. J Vasc Surg 37:8–15PubMedCrossRefGoogle Scholar
  58. 58.
    Nyheim T, Staxrud LE, Rosen L, et al. (2013) Review of postoperative CT and ultrasound for endovascular aneurysm repair using Talent stent graft: can we simplify the surveillance protocol and reduce the number of CT scans? Acta Radiol 54:54–58PubMedCrossRefGoogle Scholar
  59. 59.
    Sun Z (2006) Diagnostic value of color duplex ultrasonography in the follow-up of endovascular repair of abdominal aortic aneurysm. JVIR 17:759–764PubMedCrossRefGoogle Scholar
  60. 60.
    Cantisani V, Grazhdani H, Clevert D-A, et al. (2015) EVAR: benefits of CEUS for monitoring stent-graft status. Eur J Radiol 84:1658–1665PubMedCrossRefGoogle Scholar
  61. 61.
    Napoli V, Bargellini I, Sardella SG, et al. (2004) Abdominal aortic aneurysm: contrast-enhanced US for missed endoleaks after endoluminal repair. Radiology 233:217–225PubMedCrossRefGoogle Scholar
  62. 62.
    Ten Bosch JA, Rouwet EV, Peters CTH, et al. (2010) Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair. JVIR 21:638–643PubMedCrossRefGoogle Scholar
  63. 63.
    Ashoke R, Brown LC, Rodway A, et al. (2005) Color duplex ultrasonography is insensitive for the detection of endoleak after aortic endografting: a systematic review. J Endovasc Ther 12:297–305PubMedCrossRefGoogle Scholar
  64. 64.
    Roos JE, Hellinger JC, Hallet R, et al. (2005) Detection of endograft fractures with multidetector row computed tomography. J Vasc Surg 42:1002–1006PubMedCrossRefGoogle Scholar
  65. 65.
    Tam MDBS, Laycock SD, Brown JRI, Jakeways M (2013) 3D printing of an aortic aneurysm to facilitate decision making and device selection for endovascular aneurysm repair in complex neck anatomy. J Endovasc Ther 20:863–867PubMedCrossRefGoogle Scholar
  66. 66.
    Tam MD, Latham T, Brown JRI, Jakeways M (2014) Use of a 3D printed hollow aortic model to assist EVAR planning in a case with complex neck anatomy: potential of 3D printing to improve patient outcome. J Endovasc Ther 21:760–762PubMedCrossRefGoogle Scholar
  67. 67.
    Armerding MD, Rubin GD, Beaulieu CF, et al. (2000) Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography. Radiology 215:138–146PubMedCrossRefGoogle Scholar
  68. 68.
    Bobadilla JL, Suwanabol PA, Reeder SB, et al. (2013) Clinical implications of non-contrast-enhanced computed tomography for follow-up after endovascular abdominal aortic aneurysm repair. Ann Vasc Surg 27:1042–1048PubMedCrossRefGoogle Scholar
  69. 69.
    Macari M, Chandarana H, Schmidt B, et al. (2006) Abdominal aortic aneurysm: can the arterial phase at CT evaluation after endovascular repair be eliminated to reduce radiation dose? Radiology 241:908–914PubMedCrossRefGoogle Scholar
  70. 70.
    Hansen NJ, Kaza RK, Maturen KE, Liu PS, Platt JF (2014) Evaluation of low-dose CT angiography with model-based iterative reconstruction after endovascular aneurysm repair of a thoracic or abdominal aortic aneurysm. Am J Roentgenol 202:648–655CrossRefGoogle Scholar
  71. 71.
    Flors L, Leiva-Salinas C, Norton PT, Patrie JT, Hagspiel KD (2013) Endoleak detection after endovascular repair of thoracic aortic aneurysm using dual-source dual-energy CT: suitable scanning protocols and potential radiation dose reduction. Am J Roentgenol 200:451–460CrossRefGoogle Scholar
  72. 72.
    Szucs-Farkas Z, Semadeni M, Bensler S, et al. (2009) Endoleak detection with CT angiography in an abdominal aortic aneurysm phantom: effect of tube energy, simulated patient size, and physical properties of endoleaks. Radiology 251:590–598PubMedCrossRefGoogle Scholar
  73. 73.
    Schindera ST, Graca P, Patak MA, et al. (2009) Thoracoabdominal-aortoiliac multidetector-row CT angiography at 80 and 100 kVp: assessment of image quality and radiation dose. Investig Radiol 44:650–655CrossRefGoogle Scholar
  74. 74.
    Schoepf UJ, Meinel FG (eds) (2016) Multidetector-row CT of the Thorax, 2nd edn. Cham: Springer, pp 37–57Google Scholar
  75. 75.
    Ayuso JR, de Caralt TM, Pages M, et al. (2004) MRA is useful as a follow-up technique after endovascular repair of aortic aneurysms with nitinol endoprostheses. J Magn Reson Imaging 20:803–810PubMedCrossRefGoogle Scholar
  76. 76.
    Pandey N, Litt H (2015) Surveillance imaging following endovascular aneurysm repair. Semin Interv Radiol 32:239–248CrossRefGoogle Scholar
  77. 77.
    Lookstein RA, Goldman J, Pukin L, Marin ML (2004) Time-resolved magnetic resonance angiography as a noninvasive method to characterize endoleaks: initial results compared with conventional angiography. J Vasc Surg 39:27–33PubMedCrossRefGoogle Scholar
  78. 78.
    Hope TA, Zarins CK, Herfkens RJ (2009) Initial experience characterizing a type I endoleak from velocity profiles using time-resolved three-dimensional phase-contrast MRI. J Vasc Surg 49:1580–1584PubMedCrossRefGoogle Scholar
  79. 79.
    Sakata M, Takehara Y, Katahashi K, et al. (2016) Hemodynamic analysis of endoleaks after endovascular abdominal aortic aneurysm repair by using 4-dimensional flow-sensitive magnetic resonance imaging. Circ J 80:1715–1725PubMedCrossRefGoogle Scholar
  80. 80.
    van Bogerijen GHW, van Herwaarden JA, Conti M, et al. (2014) Importance of dynamic aortic evaluation in planning TEVAR. Ann Cardiothorac Surg 3:300–306PubMedPubMedCentralGoogle Scholar
  81. 81.
    Resta EC, Secchi F, Giardino A, et al. (2013) Non-contrast MR imaging for detecting endoleak after abdominal endovascular aortic repair. Int J Cardiovasc Imaging 29:229–235PubMedCrossRefGoogle Scholar
  82. 82.
    Baum RA, Carpenter JP, Golden MA, et al. (2002) Treatment of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms: comparison of transarterial and translumbar techniques. J Vasc Surg 35:23–29PubMedCrossRefGoogle Scholar
  83. 83.
    Rosen RJ, Green RM (2008) Endoleak management following endovascular aneurysm repair. JVIR 19:S37–S43PubMedCrossRefGoogle Scholar
  84. 84.
    Shah A, Stavropoulos SW (2009) Imaging surveillance following endovascular aneurysm repair. Semin Interv Radiol 26:10–16CrossRefGoogle Scholar
  85. 85.
    Lifeline Registry of EVAR Publications Committee (2005) Lifeline registry of endovascular aneurysm repair: long-term primary outcome measures. J Vasc Surg 42:1–10CrossRefGoogle Scholar
  86. 86.
    Wilt TJ, Lederle FA, Macdonald R, et al. (2006) Comparison of endovascular and open surgical repairs for abdominal aortic aneurysm. Evid Rep Technol Assess (Full Rep) 144:1–113Google Scholar
  87. 87.
    Stavropoulos SW, Clark TWI, Carpenter JP, et al. (2005) Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms. JVIR 16:663–667PubMedCrossRefGoogle Scholar
  88. 88.
    Ullery BW, Tran K, Itoga NK, Dalman RL, Lee JT (2017) Natural history of gutter-related type Ia endoleaks after snorkel/chimney endovascular aneurysm repair. J Vasc Surg 65:981–990PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Ueda T, Takaoka H, Petrovitch I, Rubin GD (2014) Detection of broken sutures and metal-ring fractures in AneuRx stent-grafts by using three-dimensional CT angiography after endovascular abdominal aortic aneurysm repair: association with late endoleak development and device migration. Radiology 272:275–283PubMedCrossRefGoogle Scholar
  90. 90.
    Arko FR, Rubin GD, Johnson BL, et al. (2001) Type-II endoleaks following endovascular AAA repair: preoperative predictors and long-term effects. J Endovasc Ther 8:503–510PubMedCrossRefGoogle Scholar
  91. 91.
    van Marrewijk CJ, Fransen G, Laheij RJF, Harris PL, Buth J (2004) EUROSTAR Collaborators. Is a type II endoleak after EVAR a harbinger of risk? Causes and outcome of open conversion and aneurysm rupture during follow-up. Eur J Vasc Endovasc Surg 27:128–137PubMedCrossRefGoogle Scholar
  92. 92.
    Jones JE, Atkins MD, Brewster DC, et al. (2007) Persistent type 2 endoleak after endovascular repair of abdominal aortic aneurysm is associated with adverse late outcomes. J Vasc Surg 46:1–8PubMedCrossRefGoogle Scholar
  93. 93.
    Veith FJ, Baum RA, Ohki T, et al. (2002) Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference. J Vasc Surg 35:1029–1035PubMedCrossRefGoogle Scholar
  94. 94.
    Liaw JVP, Clark M, Gibbs R, et al. (2009) Update: complications and management of infrarenal EVAR. Eur J Radiol 71:541–551PubMedCrossRefGoogle Scholar
  95. 95.
    Nolz R, Teufelsbauer H, Asenbaum U, et al. (2012) Type II endoleaks after endovascular repair of abdominal aortic aneurysms: fate of the aneurysm sac and neck changes during long-term follow-up. J Endovasc Ther 19:193–199PubMedCrossRefGoogle Scholar
  96. 96.
    Stavropoulos SW, Marin H, Fairman RM, et al. (2005) Recurrent endoleak detection and measurement of aneurysm size with CTA after coil embolization of endoleaks. JVIR 16:1313–1317PubMedCrossRefGoogle Scholar
  97. 97.
    Maleux G, Poorteman L, Laenen A, et al. (2017) Incidence, etiology, and management of type III endoleak after endovascular aortic repair. J Vasc Surg 66:1056–1064PubMedCrossRefGoogle Scholar
  98. 98.
    Ricotta JJ (2010) Endoleak management and postoperative surveillance following endovascular repair of thoracic aortic aneurysms. J Vasc Surg 52:91S–99SPubMedCrossRefGoogle Scholar
  99. 99.
    Trocciola SM, Dayal R, Chaer RA, et al. (2006) The development of endotension is associated with increased transmission of pressure and serous components in porous expanded polytetrafluoroethylene stent-grafts: characterization using a canine model. J Vasc Surg 43:109–116PubMedCrossRefGoogle Scholar
  100. 100.
    Filippi F, Tirotti C, Stella N, Rizzo L, Taurino M (2013) Endotension-related aortic sac rupture treated by endograft relining. Vascular 21:113–115PubMedCrossRefGoogle Scholar
  101. 101.
    Perry RJT, Martin MJ, Eckert MJ, Sohn VY, Steele SR (2008) Colonic ischemia complicating open vs endovascular abdominal aortic aneurysm repair. J Vasc Surg 48:272–277PubMedCrossRefGoogle Scholar
  102. 102.
    Wald R, Waikar SS, Liangos O, et al. (2006) Acute renal failure after endovascular vs open repair of abdominal aortic aneurysm. J Vasc Surg 43:460–466 (Discussion 466)PubMedCrossRefGoogle Scholar
  103. 103.
    Zettervall SL, Ultee KHJ, Soden PA, et al. (2017) Predictors of renal dysfunction after endovascular and open repair of abdominal aortic aneurysms. J Vasc Surg 65:991–996PubMedCrossRefGoogle Scholar
  104. 104.
    Grant SW, Grayson AD, Grant MJ, Purkayastha D, McCollum CN (2012) What are the risk factors for renal failure following open elective abdominal aortic aneurysm repair? Eur J Vasc Endovasc Surg 43:182–187PubMedCrossRefGoogle Scholar
  105. 105.
    Belenky A, Atar E, Orron DE, et al. (2014) Endovascular abdominal aortic aneurysm repair using transvenous intravascular US catheter guidance in patients with chronic renal failure. JVIR 25:702–706PubMedCrossRefGoogle Scholar
  106. 106.
    Zarins CK, Bloch DA, Crabtree T, et al. (2003) Stent graft migration after endovascular aneurysm repair: importance of proximal fixation. J Vasc Surg 38:1264–1272 (Discussion 1272)PubMedCrossRefGoogle Scholar
  107. 107.
    Sampaio SM, Panneton JM, Mozes G, et al. (2005) AneuRx device migration: incidence, risk factors, and consequences. Ann Vasc Surg 19:178–185PubMedCrossRefGoogle Scholar
  108. 108.
    Stavropoulos SW, Charagundla SR (2007) Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair. Radiology 243:641–655PubMedCrossRefGoogle Scholar
  109. 109.
    Resch T, Ivancev K, Brunkwall J, et al. (1999) Distal migration of stent-grafts after endovascular repair of abdominal aortic aneurysms. JVIR 10:257–264 (Discussion 265–276)PubMedCrossRefGoogle Scholar
  110. 110.
    Spanos K, Karathanos C, Saleptsis V, Giannoukas AD (2016) Systematic review and meta-analysis of migration after endovascular abdominal aortic aneurysm repair. Vascular 24:323–336PubMedCrossRefGoogle Scholar
  111. 111.
    Pintoux D, Chaillou P, Azema L, et al. (2011) Long-term influence of suprarenal or infrarenal fixation on proximal neck dilatation and stentgraft migration after EVAR. Ann Vasc Surg 25:1012–1019PubMedCrossRefGoogle Scholar
  112. 112.
    Rafii BY, Abilez OJ, Benharash P, Zarins CK (2008) Lateral movement of endografts within the aneurysm sac is an indicator of stent-graft instability. J Endovasc Ther 15:335–343PubMedCrossRefGoogle Scholar
  113. 113.
    Hellinger JC (2005) Endovascular repair of thoracic and abdominal aortic aneurysms: pre- and postprocedural imaging. Tech Vasc Interv Radiol 8:2–15PubMedCrossRefGoogle Scholar
  114. 114.
    Maleux G, Koolen M, Heye S, Nevelsteen A (2008) Limb occlusion after endovascular repair of abdominal aortic aneurysms with supported endografts. JVIR 19:1409–1412PubMedCrossRefGoogle Scholar
  115. 115.
    Fairman RM, Baum RA, Carpenter JP, et al. (2002) Limb interventions in patients undergoing treatment with an unsupported bifurcated aortic endograft system: a review of the Phase II EVT Trial. J Vasc Surg 36:118–126PubMedCrossRefGoogle Scholar
  116. 116.
    Mantas GK, Antonopoulos CN, Sfyroeras GS, et al. (2015) Factors predisposing to endograft limb occlusion after endovascular aortic repair. Eur J Vasc Endovasc Surg 49:39–44PubMedCrossRefGoogle Scholar
  117. 117.
    Maleux G, Koolen M, Heye S, Heremans B, Nevelsteen A (2008) Mural thrombotic deposits in abdominal aortic endografts are common and do not require additional treatment at short-term and midterm follow-up. JVIR 19:1558–1562PubMedCrossRefGoogle Scholar
  118. 118.
    Fatima J, Duncan AA, de Grandis E, et al. (2013) Treatment strategies and outcomes in patients with infected aortic endografts. J Vasc Surg 58:371–379PubMedCrossRefGoogle Scholar
  119. 119.
    Sharif MA, Lee B, Lau LL, et al. (2007) Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair. J Vasc Surg 46:442–448PubMedCrossRefGoogle Scholar
  120. 120.
    van den Berg HR, Leijdekkers VJ, Vahl A (2006) Aortic stent-graft infection following septic complications of a kidney stone. Cardiovasc Intervent Radiol 29:443–445PubMedCrossRefGoogle Scholar
  121. 121.
    Bergqvist D, Björck M (2009) Secondary arterioenteric fistulation: a systematic literature analysis. Eur J Vasc Endovasc Surg 37:31–42PubMedCrossRefGoogle Scholar
  122. 122.
    Becquemin J-P, Allaire E, Desgranges P, Kobeiter H (2005) Delayed complications following EVAR. Tech Vasc Interv Radiol 8:30–40PubMedCrossRefGoogle Scholar
  123. 123.
    Mehta M, Paty PSK, Roddy SP, et al. (2011) Treatment options for delayed AAA rupture following endovascular repair. J Vasc Surg 53:14–20PubMedCrossRefGoogle Scholar
  124. 124.
    Hiramoto JS, Reilly LM, Schneider DB, et al. (2007) Long-term outcome and reintervention after endovascular abdominal aortic aneurysm repair using the Zenith stent graft. J Vasc Surg 45:461–466 (Discussion 465)PubMedCrossRefGoogle Scholar
  125. 125.
    Bashir MR, Ferral H, Jacobs C, McCarthy W, Goldin M (2009) Endoleaks after endovascular abdominal aortic aneurysm repair: management strategies according to CT findings. AJR 192:W178–W186PubMedCrossRefGoogle Scholar
  126. 126.
    Alerci M, Oberson M, Fogliata A, et al. (2009) Prospective, intra individual comparison of MRI versus MDCT for endoleak detection after endovascular repair of abdominal aortic aneurysms. Eur Radiol 19:1223–1231PubMedCrossRefGoogle Scholar
  127. 127.
    Eliason JL, Upchurch GR (2008) Endovascular abdominal aortic aneurysm repair. Circulation 117:1738–1744PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Richard L. Hallett
    • 1
    • 2
    • 3
  • Brant W. Ullery
    • 4
  • Dominik Fleischmann
    • 1
  1. 1.Department of Radiology, Cardiovascular Imaging SectionStanford University Hospital and ClinicsStanfordUSA
  2. 2.St. Vincent Heart Center of IndianaIndianapolisUSA
  3. 3.Northwest Radiology NetworkIndianapolisUSA
  4. 4.Department of Cardiovascular SurgeryProvidence Heart and Vascular InstitutePortlandUSA

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