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 IV Contrast Typical CT follow-up after endovascular thoracoabdominal aortic repair incorporates arterial and delayed venous phases to evaluate for endoleak [77]. However, unenhanced CT can be used to evaluate aortic caliber to detect changes to a thoracoabdominal aneurysm or aneurysmal degeneration of a thoracoabdominal dissection. Drawbacks of unenhanced imaging include an inability to identify endoleak, evaluate branch vessel patency, or evaluate for false lumen thrombosis in aortic dissection. Nonetheless, some authors have advocated for routine use of noncontrast-enhanced CT over contrast-enhanced CT in patients after EVAR with stable aneurysm sac size, with contrast-enhanced CTA used for evaluation if aortic sac size changes [32,76]. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest and Abdomen With IV Contrast There is no relevant literature regarding venous phase CT chest and abdomen for the follow-up of endovascular repair of thoracoabdominal aneurysm or dissection. Compared with CT of the chest, abdomen, and pelvis, evaluation of the chest and abdomen only without imaging of the pelvis may fail to detect changing or new Thoracoabdominal Aortic Aneurysm or Dissection pathology in the pelvic vasculature. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest and Abdomen Without and With IV Contrast There is no relevant literature for venous and unenhanced CT without an arterial phase for follow-up after thoracoabdominal endovascular repair.
Thoracoabdominal Aneurysm or Dissection Treatment Planning and Follow Up. 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 IV Contrast Typical CT follow-up after endovascular thoracoabdominal aortic repair incorporates arterial and delayed venous phases to evaluate for endoleak [77]. However, unenhanced CT can be used to evaluate aortic caliber to detect changes to a thoracoabdominal aneurysm or aneurysmal degeneration of a thoracoabdominal dissection. Drawbacks of unenhanced imaging include an inability to identify endoleak, evaluate branch vessel patency, or evaluate for false lumen thrombosis in aortic dissection. Nonetheless, some authors have advocated for routine use of noncontrast-enhanced CT over contrast-enhanced CT in patients after EVAR with stable aneurysm sac size, with contrast-enhanced CTA used for evaluation if aortic sac size changes [32,76]. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest and Abdomen With IV Contrast There is no relevant literature regarding venous phase CT chest and abdomen for the follow-up of endovascular repair of thoracoabdominal aneurysm or dissection. Compared with CT of the chest, abdomen, and pelvis, evaluation of the chest and abdomen only without imaging of the pelvis may fail to detect changing or new Thoracoabdominal Aortic Aneurysm or Dissection pathology in the pelvic vasculature. If venous phase or unenhanced CT has already been performed, additional imaging with CTA may not be required in some patients. CT Chest and Abdomen Without and With IV Contrast There is no relevant literature for venous and unenhanced CT without an arterial phase for follow-up after thoracoabdominal endovascular repair.