Ecografía doppler en el seguimiento de la reparación endovascular del aneurisma de aorta abdominal

2020 
An endofuge is defined as persistent blood flow in the aneurysmal sac. Its incidence is approximately 25% and al-though most of them are "benign", in other cases they can cause the aneurysm to pressurize, increasing its size and increasing the risk of rupture.The aim of this study was to analyze the diagnostic validity of doppler ultrasound with respect to CT in the detection of endofugues and aneurysm sac growth, as well as analyzing morphological and hemodynamic characteristics in the monitoring of endofugues with doppler ultrasound.A descriptive, retrospective study was conducted in which 142 patients, operated by endovascular repair between 2014 and 2019, were followed postoperatively according to the protocol of the Angiology and Vascular Surgery Service of La Fe Hospital: angioTC and doppler ultrasound in our Vascular Diagnostic Laboratory on a regular basis (at the postoperative month and then annually).During the follow-up period a total of 28 endofuges were detected (incidence of 20%), most of them corresponding to type II (65% of them). Types IA, IB and III were associated with sac growth (0.84 cm average growth). In one case the aneurysm ruptured. Compared with the gold standard of CT, we obtained with doppler ultrasound a sensitivity of 66%, a specificity of 95%, a positive predictive value of 92% and a negative predictive value of 95%. The follow-up with ED of patients operated by EVAR is useful and effective in the detection of endofuges, being a non-invasive test that avoids radiological exposure and nephrotoxicity. However, given the sensitivity, it should be complemented with CT in cases of persistent endofuge and aneurysm sac growth detected by ED.
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