However, it fails to demonstrate mural thrombus, thereby limiting diameter measurements and landing zone assessment. Though less sensitive than CTA in detecting endoleaks, aortography is able to demonstrate the direction of blood flow in or out of the aneurysm sac, rendering it more accurate than CTA in classifying endoleaks [43]. Although traditional aortography relies on iodinated contrast material, recent studies suggest that carbon dioxide may be an acceptable alternative for evaluating endoleaks in patients at risk for contrast-related nephropathy [44,45]. MRA The major advantage of MR angiography (MRA) relative to CTA is improved soft tissue characterization. Despite relatively low nephrotoxicity, gadolinium-based contrast media (GBCM) have been linked to nephrogenic systemic fibrosis (NSF) [46]. As such, evaluation of renal function in high-risk patients before administering a GBCM long scanning duration, patient claustrophobia, decreased spatial resolution, and contraindication in patients with certain implantable devices. MRA is also limited in its ability to detect intimal calcification [33]. Additionally, susceptibility artifact from the metal interstices of the stent graft presents a diagnostic challenge for assessing device integrity and may mimic graft stenosis. Although the presence of an implanted cardiac pacemaker was previously an absolute contraindication to MRI, several new models are FDA-approved for conditional use. Superior soft-tissue characterization inherent to MRA may assist clinicians in differentiating slow-growing aneurysms from fast-growing aneurysms. A recent study demonstrated that AAAs containing intraluminal thrombus that have high T1-weighted signal intensity are associated with higher growth rates [47]. US Color duplex ultrasound (CDUS) is a noninvasive imaging modality that is portable and safe, sparing patients from nephrotoxic contrast material administration.
Abdominal Aortic Aneurysm or Dissection Interventional Planning and Follow up. However, it fails to demonstrate mural thrombus, thereby limiting diameter measurements and landing zone assessment. Though less sensitive than CTA in detecting endoleaks, aortography is able to demonstrate the direction of blood flow in or out of the aneurysm sac, rendering it more accurate than CTA in classifying endoleaks [43]. Although traditional aortography relies on iodinated contrast material, recent studies suggest that carbon dioxide may be an acceptable alternative for evaluating endoleaks in patients at risk for contrast-related nephropathy [44,45]. MRA The major advantage of MR angiography (MRA) relative to CTA is improved soft tissue characterization. Despite relatively low nephrotoxicity, gadolinium-based contrast media (GBCM) have been linked to nephrogenic systemic fibrosis (NSF) [46]. As such, evaluation of renal function in high-risk patients before administering a GBCM long scanning duration, patient claustrophobia, decreased spatial resolution, and contraindication in patients with certain implantable devices. MRA is also limited in its ability to detect intimal calcification [33]. Additionally, susceptibility artifact from the metal interstices of the stent graft presents a diagnostic challenge for assessing device integrity and may mimic graft stenosis. Although the presence of an implanted cardiac pacemaker was previously an absolute contraindication to MRI, several new models are FDA-approved for conditional use. Superior soft-tissue characterization inherent to MRA may assist clinicians in differentiating slow-growing aneurysms from fast-growing aneurysms. A recent study demonstrated that AAAs containing intraluminal thrombus that have high T1-weighted signal intensity are associated with higher growth rates [47]. US Color duplex ultrasound (CDUS) is a noninvasive imaging modality that is portable and safe, sparing patients from nephrotoxic contrast material administration.