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European Radiology
Published in: European Radiology 5/2017

01-05-2017 | Experimental

Abdominal aortic aneurysm follow-up by shear wave elasticity imaging after endovascular repair in a canine model

Authors: Antony Bertrand-Grenier, Sophie Lerouge, An Tang, Eli Salloum, Eric Therasse, Claude Kauffmann, Hélène Héon, Igor Salazkin, Guy Cloutier, Gilles Soulez

Published in: European Radiology | Issue 5/2017

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Abstract

Objectives

To investigate if shear wave imaging (SWI) can detect endoleaks and characterize thrombus organization in abdominal aortic aneurysms (AAAs) after endovascular aneurysm repair.

Methods

Stent grafts (SGs) were implanted in 18 dogs after surgical creation of type I endoleaks (four AAAs), type II endoleaks (13 AAAs) and no endoleaks (one AAA). Color flow Doppler ultrasonography (DUS) and SWI were performed before SG implantation (baseline), on days 7, 30 and 90 after SG implantation, and on the day of the sacrifice (day 180). Angiography, CT scans and macroscopic tissue sections obtained on day 180 were evaluated for the presence, size and type of endoleaks, and thrombi were characterized as fresh or organized. Endoleak areas in aneurysm sacs were identified on SWI by two readers and compared with their appearance on DUS, CT scans and macroscopic examination. Elasticity moduli were calculated in different regions (endoleaks, and fresh and organized thrombi).

Results

All 17 endoleaks (100 %) were identified by reader 1, whereas 16 of 17 (94 %) were detected by reader 2. Elasticity moduli in endoleaks, and in areas of organized thrombi and fresh thrombi were 0.2 ± 0.4, 90.0 ± 48.2 and 13.6 ± 4.5 kPa, respectively (P < 0.001 between groups). SWI detected endoleaks while DUS (three endoleaks) and CT (one endoleak) did not.

Conclusions

SWI has the potential to detect endoleaks and evaluate thrombus organization based on the measurement of elasticity.

Key points

• SWI has the potential to detect endoleaks in post-EVAR follow-up.
• SWI has the potential to characterize thrombus organization in post-EVAR follow-up.
• SWI may be combined with DUS in post-EVAR surveillance of endoleak.
Literature
1.
Eliason JL, Upchurch GR Jr (2009) Endovascular treatment of aortic aneurysms: state of the art. Curr Treat Options Cardiovasc Med 11(2):136–145CrossRefPubMed
2.
Zhou W, Blay E Jr, Varu V et al (2014) Outcome and clinical significance of delayed endoleaks after endovascular aneurysm repair. J Vasc Surg 59(4):915–920CrossRefPubMed
3.
van Beek SC, Legemate DA, Vahl A et al (2014) External validation of the Endovascular aneurysm repair Risk Assessment model in predicting survival, reinterventions, and endoleaks after endovascular aneurysm repair. J Vasc Surg 59(6):1555–1561.e3CrossRefPubMed
4.
Steingruber IE, Neuhauser B, Seiler R et al (2006) Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: a 10-year single-center experience. Eur J Radiol 59(3):384–392CrossRefPubMed
5.
Brown LC, Brown EA, Greenhalgh RM, Powell JT, Thompson SG (2010) Renal function and abdominal aortic aneurysm (AAA): the impact of different management strategies on long-term renal function in the UK EndoVascular Aneurysm Repair (EVAR) Trials. Ann Surg 251(5):966–975CrossRefPubMed
6.
Noll RE Jr, Tonnessen BH, Mannava K, Money SR, Sternbergh WC 3rd (2007) Long-term postplacement cost after endovascular aneurysm repair. J Vasc Surg 46(1):9–15, discussion 15CrossRefPubMed
7.
White HA, Macdonald S (2010) Estimating risk associated with radiation exposure during follow-up after endovascular aortic repair (EVAR). J Cardiovasc Surg (Torino) 51(1):95–104
8.
Müller-Wille R, Borgmann T, Wohlgemuth WA et al (2014) Dual-energy computed tomography after endovascular aortic aneurysm repair: the role of hard plaque imaging for endoleak detection. Eur Radiol 24(10):2449–2457CrossRefPubMed
9.
AbuRahma AF, Welch CA, Mullins BB, Dyer B (2005) Computed tomography versus color duplex ultrasound for surveillance of abdominal aortic stent-grafts. J Endovasc Ther 12(5):568–573CrossRefPubMed
10.
Giannoni MF, Palombo G, Sbarigia E, Speziale F, Zaccaria A, Fiorani P (2003) Contrast-enhanced ultrasound imaging for aortic stent-graft surveillance. J Endovasc Ther 10:208–217PubMed
11.
Ten Bosch JA, Rouwet EV, Peters CT et al (2010) Contrast-enhanced ultrasound versus computed tomographic angiography for surveillance of endovascular abdominal aortic aneurysm repair. J Vasc Interv Radiol 21(5):638–643CrossRefPubMed
12.
Bendick PJ, Zelenock GB, Bove PG, Long GW, Shanley CJ, Brown OW (2003) Duplex ultrasound imaging with an ultrasound contrast agent: the economic alternative to CT angiography for aortic stent graft surveillance. Vasc Endovasc Surg 37:165–170CrossRef
13.
Karthikesalingam A, Al-Jundi W, Jackson D et al (2012) Systematic review and meta-analysis of duplex ultrasonography, contrast-enhanced ultrasonography or computed tomography for surveillance after endovascular aneurysm repair. Br J Surg 99(11):1514–1523CrossRefPubMed
14.
Abbas A, Hansrani V, Sedgwick N, Ghosh J, McCollum CN (2014) 3D contrast enhanced ultrasound for detecting endoleak following endovascular aneurysm repair (EVAR). Eur J Vasc Endovasc Surg 47(5):487–492CrossRefPubMed
15.
Wilson SR, Greenbaum LD, Goldberg BB (2009) Contrast-enhanced ultrasound: what is the evidence and what are the obstacles? AJR Am J Roentgenol 193:55–60CrossRefPubMed
16.
Sarvazyan AP, Rudenko OV, Swanson SD, Fowlkes JB, Emelianov SY (1998) Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. Ultrasound Med Biol 24(9):1419–1435CrossRefPubMed
17.
Gürtler VM, Rjosk-Dendorfer D, Reiser M, Clevert DA (2014) Comparison of contrast-enhanced ultrasound and compression elastography in follow-up after endovascular aortic aneurysm repair. Clin Hemorheol Microcirc 57(2):175–183PubMed
18.
Lerner LS (1996) Modern Physics for Scientists and Engineers, Volume 2. Chapter 22: Summing up. Jones & Bartlett, London, p 622
19.
20.
21.
Lerouge S, Raymond J, Salazkin I et al (2004) Endovascular aortic aneurysm repair with stent-grafts: experimental models can reproduce endoleaks. J Vasc Interv Radiol 15(9):971–979CrossRefPubMed
22.
Soulez G, Lerouge S, Salazkin I, Darsaut T, Oliva VL, Raymond J (2007) Type I and collateral flow in experimental aneurysm models treated with stent-grafts. J Vasc Interv Radiol 18(2):265–272CrossRefPubMed
23.
Salloum E, Bertrand-Grenier A, Lerouge S et al (2016) Abdominal aortic aneurysm: follow-up with noninvasive vascular elastography in a canine model. Radiology 279(2):410–419CrossRefPubMed
24.
Maurice RL, Ohayon J, Frétigny Y, Bertrand M, Soulez G, Cloutier G (2004) Noninvasive vascular elastography: theoretical framework. IEEE Trans Med Imaging 23(2):164–180CrossRefPubMed
25.
Stavropoulos SW, Clark TW, Carpenter JP et al (2005) Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms. J Vasc Interv Radiol 16(5):663–667CrossRefPubMed
26.
Cohen J (1960) A coefficient of agreement for nominal scales. Educ Psychol Meas 20(1):37–46CrossRef
27.
Gürtler VM, Sommer WH, Meimarakis G et al (2013) A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after endovascular aneurysm repair. J Vasc Surg 58(2):340–345CrossRefPubMed
28.
Perini P, Sediri I, Midulla M, Delsart P, Gautier C, Haulon S (2012) Contrast-enhanced ultrasound vs. CT angiography in fenestrated EVAR surveillance: a single-center comparison. J Endovasc Ther 19(5):648–655CrossRefPubMed
29.
Elkouri S, Panneton JM, Andrews JC et al (2004) Computed tomography and ultrasound in follow-up of patients after endovascular repair of abdominal aortic aneurysm. Ann Vasc Surg 18(3):271–279CrossRefPubMed
30.
Risberg B, Delle M, Lönn L, Syk I (2004) Management of aneurysm sac hygroma. J Endovasc Ther 11(2):191–195CrossRefPubMed
31.
Mfoumou E, Tripette J, Blostein M, Cloutier G (2014) Time-dependent hardening of blood clots quantitatively measured in vivo with shear-wave ultrasound imaging in a rabbit model of venous thrombosis. Thromb Res 133(2):265–271CrossRefPubMed
32.
Kulcsár Z, Houdart E, Bonafé A et al (2011) Intra-aneurysmal thrombosis as a possible cause of delayed aneurysm rupture after flow-diversion treatment. AJNR Am J Neuroradiol 32(1):20–25PubMed
33.
Ashton JH, Vande Geest JP, Simon BR, Haskett DG (2009) Compressive mechanical properties of the intraluminal thrombus in abdominal aortic aneurysms and fibrin-based thrombus mimics. J Biomech 42(3):197–201CrossRefPubMed
34.
Wang DH, Makaroun M, Webster MW, Vorp DA (2001) Mechanical properties and microstructure of intraluminal thrombus from abdominal aortic aneurysm. J Biomech Eng 123(6):536–539CrossRefPubMed
35.
Gasser TC, Görgülü G, Folkesson M, Swedenborg J (2008) Failure properties of intraluminal thrombus in abdominal aortic aneurysm under static and pulsating mechanical loads. J Vasc Surg 48(1):179–188CrossRefPubMed
36.
Cornelissen SA, van der Laan MJ, Vincken KL et al (2011) Use of multispectral MRI to monitor aneurysm sac contents after endovascular abdominal aortic aneurysm repair. J Endovasc Ther 18(3):274–279CrossRefPubMed
37.
Engellau L, Larsson EM, Albrechtsson U et al (1998) Magnetic resonance imaging and MR angiography of endoluminally treated abdominal aortic aneurysms. Eur J Vasc Endovasc Surg 15(3):212–219CrossRefPubMed
38.
Mori K, Saida T, Sato F et al (2016) Endoleak detection after endovascular aneurysm repair using unenhanced MRI with flow suppression technique: feasibility study in comparison with contrast-enhanced CT. Eur Radiol. doi:10.​1007/​s00330-016-4315-5
39.
Weigel S, Tombach B, Maintz D et al (2003) Thoracic aortic stent graft: comparison of contrast-enhanced MR angiography and CT angiography in the follow-up: initial results. Eur Radiol 13(7):1628–1634CrossRefPubMed
40.
He CM, Roach MR (1994) The composition and mechanical properties of abdominal aortic aneurysms. J Vasc Surg 20(1):6–13CrossRefPubMed
41.
Metadata
Title
Abdominal aortic aneurysm follow-up by shear wave elasticity imaging after endovascular repair in a canine model
Authors
Antony Bertrand-Grenier
Sophie Lerouge
An Tang
Eli Salloum
Eric Therasse
Claude Kauffmann
Hélène Héon
Igor Salazkin
Guy Cloutier
Gilles Soulez
Publication date
01-05-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 5/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4524-y

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