CT Chest, Abdomen, and Pelvis With IV Contrast There is no relevant literature regarding venous phase CT chest, abdomen, and pelvis for the follow-up of endovascular repair of thoracoabdominal aneurysm or dissection because most follow-up imaging uses an arterially timed contrast bolus in the form of a CTA (discussed below). However, contrast-enhanced CT can provide similar information as CTA in evaluating the size and extent of aortic pathology, although with a reduced sensitivity to delineating endoleak and subtle changes to aorta and branch artery diameter. Although typically not performed for the purpose of follow-up of thoracoabdominal aortic pathology, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes after endovascular repair including endoprosthesis migration or aortic rupture. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature for venous and unenhanced CT chest, abdomen, and pelvis without an arterial phase for follow-up after thoracoabdominal endovascular repair. However, contrast-enhanced CT can provide similar information as CTA in evaluating the size and extent of aortic pathology, although with a reduced sensitivity to delineating endoleak and subtle changes to aorta and branch artery diameter. Although typically not performed for the purpose of follow-up of thoracoabdominal aortic pathology, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes after endovascular repair including endoprosthesis migration or aortic rupture. The addition of a noncontrast phase would be expected to aid in identifying endoleak and distinguishing endoleak from other sources of sac/false lumen opacification, although a lack of an arterial phase limits sensitivity.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. CT Chest, Abdomen, and Pelvis With IV Contrast There is no relevant literature regarding venous phase CT chest, abdomen, and pelvis for the follow-up of endovascular repair of thoracoabdominal aneurysm or dissection because most follow-up imaging uses an arterially timed contrast bolus in the form of a CTA (discussed below). However, contrast-enhanced CT can provide similar information as CTA in evaluating the size and extent of aortic pathology, although with a reduced sensitivity to delineating endoleak and subtle changes to aorta and branch artery diameter. Although typically not performed for the purpose of follow-up of thoracoabdominal aortic pathology, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes after endovascular repair including endoprosthesis migration or aortic rupture. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest, Abdomen, and Pelvis Without and With IV Contrast There is no relevant literature for venous and unenhanced CT chest, abdomen, and pelvis without an arterial phase for follow-up after thoracoabdominal endovascular repair. However, contrast-enhanced CT can provide similar information as CTA in evaluating the size and extent of aortic pathology, although with a reduced sensitivity to delineating endoleak and subtle changes to aorta and branch artery diameter. Although typically not performed for the purpose of follow-up of thoracoabdominal aortic pathology, contrast-enhanced CT performed to evaluate for extravascular pathology can often assess for acute changes after endovascular repair including endoprosthesis migration or aortic rupture. The addition of a noncontrast phase would be expected to aid in identifying endoleak and distinguishing endoleak from other sources of sac/false lumen opacification, although a lack of an arterial phase limits sensitivity.