News - The Assessment of CO2 Automated Angiography in Type II Endoleaks Detection


Introduction. Iodinated contrast media completion angiography (ICM-A) may underestimate the presence of type II endoleak (ELII) after endovascular aortic repair (EVAR), particularly if they are at low flow. Contrast-enhanced ultrasound (CEUS) has been proposed as the gold standard in ELII detection during EVAR follow-up. Intraprocedural carbon dioxide (CO2) angiography has been shown to be useful in this setting; however no comparative studies including these three techniques are currently available. Our aim was to investigate the accuracy of a new automated CO2 angiographic (CO2-A) system in the detection of ELII, by comparing it with ICM-A and CEUS. Methods. A series of consecutive patients undergoing EVAR for abdominal aortic aneurysm (AAA) were enrolled and submitted to ICM-A and CO2-A during the procedure.The iodinated contrast media were delivered through an automatic injector connected to a pigtail catheter in the suprarenal aorta. CO2 was delivered through a recently available automatic injector connected to a 10 F sheath positioned in the external iliac artery. All patients were blindly evaluated by CEUS within postoperative day 1. The ICM-A and CO2-A ability to detect ELII was compared with that of CEUS through Cohen’s concordance
Index (?).
Results. Twenty-one patients were enrolled in the study. One (5%), seven (33%), and four (19%) ELII were detected by ICM-A, CO2-A, and CEUS, respectively. The only ELII detected by ICM-A was also detected by CO2-A and CEUS. Three cases of ELII detected by CO2-A were not detected by CEUS. All ELII detected by CEUS were visualized by CO2-A. CEUS and ICM-A showed a poor agreement (Cohen’s ?: 0.35) while CEUS and CO2-A showed a substantial agreement (Cohen’s ?: 0.65) for ELII detection.
Conclusion. CO2-A is safe and effective method for ELII detection in EVAR, with a significantly higher agreement with CEUS if compared with ICM-A. This trial is registered with 155/2015/U/Oss.

Contact us for more information.

Welcome to Angiodroid websiteDiscover our Uniqueness - ANGIODROID THE CO2 INJECTOR & ACDA Academy

We are sorry, you can access this content only if you are an Healthcare Professionist.
Angiodroid adopted this restrictions in accordance with the Italian regulations on sponsorship of medical devies (art. 21 of D.L. 24.02.97, n.46; 93/42/CEE directive; guidelines 17.02.2010)

error: Content is protected !!