Color Duplex Ultrasound As Suitable Alternative for CTA in Post EVAR Surveillance

Background: EVAR has emerged as an alternative to open AAA repair in recent times, bringing with it new diagnostic and therapeutic challenges, including the need for lifelong surveillance. Traditionally, CTA has been the gold-standard for the first post-operative scan following EVAR. However, this entails risk exposure including contrast nephropathy and radiation. Several studies have looked into CDU as an alternative tool for EVAR surveillance, with conflicting results. Aims: To examine post-operative CDU results and compare them with CTA results, used as the gold-standard. Methods: All patients who underwent an EVAR for infrarenal AAA at our institution between 2003 and 2017, and had a CTA and CDU within 30 days of the procedure were included in our analysis. Results: There was perfect correlation between CTA and CDU when examining sac size and the presence or absence of endoleak, with a good correlation when looking at the type of endoleak. Conclusion: CDU is a safe and effective post-operative EVAR surveillance tool when carried out by experienced operators in an appropriate patient population.