Ann Surg Treat Res.  2017 Jun;92(6):436-439. 10.4174/astr.2017.92.6.436.

Ultrasound fusion imaging with real-time navigation for the surveillance after endovascular aortic aneurysm repair

• Joh JH
• Han SA
• Kim SH
• Park HC

• KMID: 2387418
• DOI: http://doi.org/10.4174/astr.2017.92.6.436

Abstract

Ultrasound can be an effective alternative to computed tomography for surveillance following endovascular aneurysm repair (EVAR). Recently, ultrasound fusion imaging with the real-time navigation system was introduced. Here we described 3 patients who underwent post-EVAR surveillance using this novel technique. Complete coregistration was achieved in all patients. The origin of left renal artery was selected for the target of coregistration. Ultrasound fusion imaging was useful to differentiate the confusing lesion and to evaluate the complete resolution of endoleak and newly developed delayed endoleak. Ultrasound fusion image with real-time navigation system can be a feasible imaging tool for post-EVAR surveillance.

Keyword

Ultrasonography; X-ray computed tomography; Endovascular procedures; Aneurysm; Surveillance

MeSH Terms

Aneurysm
Aortic Aneurysm*
Endoleak
Endovascular Procedures
Humans
Renal Artery
Tomography, X-Ray Computed
Ultrasonography*

Figure

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  Fig. 1 Ultrasound system. This system was equipped with an electromagnetic tracking system, a transmitter and a small sensor mounted on the ultrasound probe.

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  Fig. 2 Ultrasound fusion imaging can differentiate the confusing lesion. It was revealed with aneurysmal sac content on ultrasound fusion image (A; white arrow). A filling defect could not be differentiated with endoleak or aneurysmal sac content in reference CT image (B; open arrow).

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  Fig. 3 Ultrasound fusion imaging reveals the complete resolution of endoleak. Follow-up ultrasound fusion imaging reveals the complete resolution of endoleak (A) shown in initial CT scanning (B, open arrow). Fusion image was completely matched. Images of inferior vena cava was located in the same position (small arrows).

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  Fig. 4 Ultrasound fusion imaging reveals the newly developed endoleak. Follow-up ultrasound fusion imaging showed the newly developed type III endoleak (A, open arrow).There was no endoleak on the initial CT scanning (B).

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