TEE provides suboptimal evaluation of suspected endoleak and should be considered only in patients in whom CTA is precluded because of severe renal dysfunction or contrast allergy [84]. US US US duplex Doppler is an alternative modality for follow-up of abdominal aortic endovascular aneurysm repair with high specificity for detection of endoleaks and high accuracy for evaluation of aneurysm sac size. The addition of contrast material makes US an even more sensitive and specific test than CTA for characterization of endoleaks [90]. Its use in TEVAR is impractical in the chest given poor acoustic windows but may provide diagnostic information for the abdominal aspect of the stent graft [38]. Radiography Radiography in the postintervention period has traditionally been used to evaluate for stent migration and integrity [71]. However, given ever-increasing improvements in CT imaging quality as well as the low incidence of stent graft fractures with currently available endograft devices, the utility of radiographic follow-up is increasingly limited [38]. surveillance interval is unclear and may be procedure and patient specific. In the postintervention follow-up evaluation, CTA is the imaging modality of choice, given its sensitivity for the detection of endoleaks, changes in aortic/aneurysm diameter, evaluation of false lumen thrombosis, and Thoracic Aorta Interventional Planning and Follow-Up assessment for device migration and integrity. MRA can provide equivalent information and is preferred for long-term follow-up of younger patients given the lack of ionizing radiation, but it can be used only with MR- compatible stent grafts. Although there are references that report on studies with design limitations, 37 well-designed or good-quality studies provide good evidence. Relative Radiation Level Designations 30-100 mSv 10-30 mSv
Thoracic Aortic Aneurysm or Dissection Treatment Planning and Follow Up. TEE provides suboptimal evaluation of suspected endoleak and should be considered only in patients in whom CTA is precluded because of severe renal dysfunction or contrast allergy [84]. US US US duplex Doppler is an alternative modality for follow-up of abdominal aortic endovascular aneurysm repair with high specificity for detection of endoleaks and high accuracy for evaluation of aneurysm sac size. The addition of contrast material makes US an even more sensitive and specific test than CTA for characterization of endoleaks [90]. Its use in TEVAR is impractical in the chest given poor acoustic windows but may provide diagnostic information for the abdominal aspect of the stent graft [38]. Radiography Radiography in the postintervention period has traditionally been used to evaluate for stent migration and integrity [71]. However, given ever-increasing improvements in CT imaging quality as well as the low incidence of stent graft fractures with currently available endograft devices, the utility of radiographic follow-up is increasingly limited [38]. surveillance interval is unclear and may be procedure and patient specific. In the postintervention follow-up evaluation, CTA is the imaging modality of choice, given its sensitivity for the detection of endoleaks, changes in aortic/aneurysm diameter, evaluation of false lumen thrombosis, and Thoracic Aorta Interventional Planning and Follow-Up assessment for device migration and integrity. MRA can provide equivalent information and is preferred for long-term follow-up of younger patients given the lack of ionizing radiation, but it can be used only with MR- compatible stent grafts. Although there are references that report on studies with design limitations, 37 well-designed or good-quality studies provide good evidence. Relative Radiation Level Designations 30-100 mSv 10-30 mSv