Intermediate Follow-Up after Endovascular Aneurysm Repair: Can We Forgo CT Scanning in Certain Patients?

Jared Tomlinson, Jo Anne McNamara, Jubin Matloubieh, Joseph Hart, Michael J. Singh, Mark G. Davies, Jeffrey M. Rhodes, Karl A. Illig

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Current recommendations for follow-up after endovascular repair of abdominal aortic aneurysms (EVAR) include yearly computed tomographic (CT) scans after the first year. We hypothesize that this is unnecessary for patients who have aneurysm sacs that are stable or shrinking at 1 year and no evidence of endoleak. To explore this hypothesis, we reviewed the records of all patients undergoing EVAR at our institution who were implanted with grafts that are currently commercially available and had a minimum of 18 months' follow-up. Of 415 patients who underwent EVAR over an 8-year period, 93 met the entry criteria. At a mean follow-up of approximately 3 years, secondary interventions were required in 13%, 39%, and 25% of patients undergoing EVAR with Zenith, AneuRx, and Excluder devices, respectively, and secondary interventions after the first year were required in 3%, 22%, and 8% of such grafts, respectively. Seventy-one patients (76%) had aneurysm sacs that were stable or shrinking at 1 year and no endoleak. Only two of these patients subsequently required reintervention. Both patients had AneuRx grafts, and both problems could have easily been identified without CT scanning. Our data support the hypothesis that patients who meet these criteria at 1 year are unlikely to have problems that cannot be identified by ultrasound and/or clinical evaluation alone and, thus, that CT scans are not necessary after this point, especially in patients with Zenith or reengineered Excluder devices.

Original languageEnglish (US)
Pages (from-to)663-670
Number of pages8
JournalAnnals of Vascular Surgery
Volume21
Issue number6
DOIs
StatePublished - Nov 2007
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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