Von Tengg-Kobligk H, Correa Londono M, Von Allmen R, Heverhagen J T, Van Den Berg J C
Interventional and Pediatric Radiology, Inselspital University Hospitals Bern, Bern, Switzerland -
J Cardiovasc Surg (Torino). 2014 Oct;55(5):563-79. Epub 2014 Jun 30.
Endovascular aortic repair (EVAR) necessitates lifelong surveillance for the patient, in order to detect complications timely. Endoleaks (ELs) are among the most common complications of EVAR. Especially type II ELs can have a very unpredictable clinical course and this can range from spontaneous sealing to aortic rupture. Subgroups of this type of EL need to be identified in order to make a proper risk stratification. Aim of this review is to describe the existing imaging techniques, including their advantages and disadvantages in the context of post-EVAR surveillance with a particular emphasis on low-flow ELs. Low flow ELs cause pressurization of the aortic aneurysm sac with a low velocity filling, leading to difficulty of detection by routine imaging protocols for EVAR surveillance, e.g. bi- or triphasic multislice computed tomographic angiography, magnetic resonance imaging and contrast enhanced ultrasound. In this article, we review the imaging possibilities of ELs and discuss the different imaging strategies available for depicting low flow ELs.
血管腔内主动脉修复术（EVAR）要求对患者进行终身监测，以便及时发现并发症。内漏（ELs）是EVAR最常见的并发症之一。尤其是II型内漏的临床病程可能非常不可预测，范围从自发闭合到主动脉破裂。需要识别这类内漏的亚组，以便进行适当的风险分层。本综述的目的是描述现有的成像技术，包括它们在EVAR术后监测背景下的优缺点，特别强调低流量内漏。低流量内漏导致主动脉瘤囊内压力升高，填充速度低，导致通过常规的EVAR监测成像方案（如双期或三期多层计算机断层血管造影、磁共振成像和对比增强超声）难以检测到。在本文中，我们回顾了内漏的成像可能性，并讨论了用于描绘低流量内漏的不同成像策略。
