Neue Applikationen und Indikationen der Kontrastmittelsonografie im Rahmen des Aortenstentings

 

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Zusammenfassung

Im postoperativen Verlauf nach endovaskulärer Stentversorgung von infrarenalen Aortenaneurysmen (EVAR) können Endoleaks auftreten, die eine weitere Therapie erforderlich machen können. Daher ist für die Follow-up-Kontrollen nach EVAR eine zuverlässige Methode zur Detektion und Verlaufskontrolle von Endoleaks sehr wichtig. Hierfür stellt die kontrastverstärkte Sonografie (CEUS) eine Methode dar, die ohne die Applikation von nephrotoxischen Kontrastmitteln auskommt und den Patienten wenig belastet. Dieses Verfahren wird zunehmend häufiger eingesetzt und erlaubt eine schnelle, nicht invasive Diagnostik im Follow-up nach EVAR. Zudem können Interventionen zur Therapie von Endoleaks ultraschallgesteuert erfolgen. Erste Erfahrungen mit dem Einsatz der CEUS im Rahmen der Implantation von Aortenstents zeigen, dass sowohl die Kontrastmittelmenge als auch die Durchleuchtungszeit verringert werden können.

Abstract

After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxid contrast media and does not stress the patient. CEUS is increasingly used and enables a quick, non-invasive follow-up examination for patient after EVAR. In addition, interventions as therapy for endoleaks may be executed using ultrasound. Initial experience with CEUS-guided aortic stenting shows that the amount of contrast media as well as X-ray time may be reduced.

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