Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography

(A) An example of a type II endoleak as demonstrated on CTA. This was shown to originate from the inferior mesenteric artery, and was not associated with an increase in aneurysm sac size, and so was managed conservatively. (B) The same endoleak demonstrated on duplex ultrasonography. The iliac limbs of the bifurcated endovascular device are shown, with abnormal color flow visible in the aneurysm sac.

Our current algorithm for post-endovascular aneurysm repair (EVAR) surveillance. Annual computed tomography angiography (CTA) has been omitted and CTA is now performed only in the presence of a positive or inconclusive duplex ultrasonography (DU), or an increase in aneurysm sac size. *Clinical assessment is carried out on each visit and our protocol also includes yearly plain abdominal radiographs.