Abstract
PURPOSE: Accurate endoleak detection and classification is critical for the follow-up of patients who have undergone endovascular aneurysm repair (EVAR). This determination is often made with computed tomography angiography (CTA). This investigation was performed to determine the accuracy of CTA in the classification of endoleaks in patients who have undergone EVAR. MATERIALS AND METHODS: Thirty-six patients with endoleaks underwent both CTA and conventional contrast digital subtraction angiography (DSA) to determine endoleak etiology. Two independent radiologists determined the source of the endoleak based on a retrospective review of the CTA. The results of the CTA-based endoleak classification were compared to the reference standard, contrast DSA. RESULTS: There was agreement regarding endoleak classification between CTA and DSA on 86% of the patients (31 of 36 patients). Correlation between the CTA reading of the two readers was 94% (34 of 36 patients), yielding a kappa statistic of 0.8. In three patients, the CTA reading incorrectly classified endoleaks as type 2 when the endoleaks were actually type 1 endoleaks on DSA. One patient was incorrectly classified as having a type 1 endoleak on CTA when it was a type 2 endoleak on DSA. Finally, one patient had a type 1 endoleak on DSA that was incorrectly classified as a type 3 endoleak on CTA. The change in CTA endoleak classification based on the DSA resulted in a significant change in patient management in four of the 36 patients (11%). CONCLUSIONS: Endoleak classification based on CTA correlates fairly well with DSA findings. However, optimal endoleak management requires performance of selective angiograms with DSA to classify endoleaks that are detected on CTA.
| Original language | English |
|---|---|
| Pages (from-to) | 663-667 |
| Number of pages | 5 |
| Journal | Journal of Vascular and Interventional Radiology |
| Volume | 16 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2005 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Radiological and Ultrasound Technology
Cite this
Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms. / Stavropoulos, S. William; Clark, Timothy W I; Carpenter, Jeffrey P.; Fairman, Ronald M.; Litt, Harold; Velazquez, Omaida C; Insko, Erik; Farner, Michael; Baum, Richard A.
In: Journal of Vascular and Interventional Radiology, Vol. 16, No. 5, 01.05.2005, p. 663-667.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of CT angiography to classify endoleaks after endovascular repair of abdominal aortic aneurysms
AU - Stavropoulos, S. William
AU - Clark, Timothy W I
AU - Carpenter, Jeffrey P.
AU - Fairman, Ronald M.
AU - Litt, Harold
AU - Velazquez, Omaida C
AU - Insko, Erik
AU - Farner, Michael
AU - Baum, Richard A.
PY - 2005/5/1
Y1 - 2005/5/1
N2 - PURPOSE: Accurate endoleak detection and classification is critical for the follow-up of patients who have undergone endovascular aneurysm repair (EVAR). This determination is often made with computed tomography angiography (CTA). This investigation was performed to determine the accuracy of CTA in the classification of endoleaks in patients who have undergone EVAR. MATERIALS AND METHODS: Thirty-six patients with endoleaks underwent both CTA and conventional contrast digital subtraction angiography (DSA) to determine endoleak etiology. Two independent radiologists determined the source of the endoleak based on a retrospective review of the CTA. The results of the CTA-based endoleak classification were compared to the reference standard, contrast DSA. RESULTS: There was agreement regarding endoleak classification between CTA and DSA on 86% of the patients (31 of 36 patients). Correlation between the CTA reading of the two readers was 94% (34 of 36 patients), yielding a kappa statistic of 0.8. In three patients, the CTA reading incorrectly classified endoleaks as type 2 when the endoleaks were actually type 1 endoleaks on DSA. One patient was incorrectly classified as having a type 1 endoleak on CTA when it was a type 2 endoleak on DSA. Finally, one patient had a type 1 endoleak on DSA that was incorrectly classified as a type 3 endoleak on CTA. The change in CTA endoleak classification based on the DSA resulted in a significant change in patient management in four of the 36 patients (11%). CONCLUSIONS: Endoleak classification based on CTA correlates fairly well with DSA findings. However, optimal endoleak management requires performance of selective angiograms with DSA to classify endoleaks that are detected on CTA.
AB - PURPOSE: Accurate endoleak detection and classification is critical for the follow-up of patients who have undergone endovascular aneurysm repair (EVAR). This determination is often made with computed tomography angiography (CTA). This investigation was performed to determine the accuracy of CTA in the classification of endoleaks in patients who have undergone EVAR. MATERIALS AND METHODS: Thirty-six patients with endoleaks underwent both CTA and conventional contrast digital subtraction angiography (DSA) to determine endoleak etiology. Two independent radiologists determined the source of the endoleak based on a retrospective review of the CTA. The results of the CTA-based endoleak classification were compared to the reference standard, contrast DSA. RESULTS: There was agreement regarding endoleak classification between CTA and DSA on 86% of the patients (31 of 36 patients). Correlation between the CTA reading of the two readers was 94% (34 of 36 patients), yielding a kappa statistic of 0.8. In three patients, the CTA reading incorrectly classified endoleaks as type 2 when the endoleaks were actually type 1 endoleaks on DSA. One patient was incorrectly classified as having a type 1 endoleak on CTA when it was a type 2 endoleak on DSA. Finally, one patient had a type 1 endoleak on DSA that was incorrectly classified as a type 3 endoleak on CTA. The change in CTA endoleak classification based on the DSA resulted in a significant change in patient management in four of the 36 patients (11%). CONCLUSIONS: Endoleak classification based on CTA correlates fairly well with DSA findings. However, optimal endoleak management requires performance of selective angiograms with DSA to classify endoleaks that are detected on CTA.
UR - http://www.scopus.com/inward/record.url?scp=18444384843&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=18444384843&partnerID=8YFLogxK
U2 - 10.1097/01.RVI.0000152386.97448.F1
DO - 10.1097/01.RVI.0000152386.97448.F1
M3 - Article
C2 - 15872321
AN - SCOPUS:18444384843
VL - 16
SP - 663
EP - 667
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
SN - 1051-0443
IS - 5
ER -