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DC Ormesher, C Lowe, A McKeown, N Sedgwick, CN McCollum, J Ghosh

EVAR Using Intraoperative 3D Contrast Enhanced Duplex Ultrasound. DC Ormesher, C Lowe, A McKeown, N Sedgwick, CN McCollum, J Ghosh. Disclosure Speaker name: ........David Ormesher........................................................................

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DC Ormesher, C Lowe, A McKeown, N Sedgwick, CN McCollum, J Ghosh

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  1. EVAR Using Intraoperative 3D Contrast Enhanced Duplex Ultrasound DC Ormesher, C Lowe, A McKeown, N Sedgwick, CN McCollum, J Ghosh

  2. Disclosure Speaker name: ........David Ormesher........................................................................ I have the following potential conflicts of interest to report: Consulting Employment in industry Shareholder in a healthcare company Owner of a healthcare company Other(s) X I do not have any potential conflict of interest

  3. Introduction

  4. 3D contrast enhanced duplex

  5. Aim Evaluate intraoperative 3D CEUS vs uniplanar angiography during EVAR Endoleak Stent deformity Renal artery perfusion

  6. Methods Prospective study of consecutive infrarenal EVAR Completion angiogram & 3D CEUS Presence of endoleak characterised along with renal perfusion and device deformity

  7. Results 19 paired 3D CEUS and completion angiograms Endoleak: 3 on angiogram (Type 1a and 2x Type 2) 10 endoleaks with 3D CEUS (3x Type 1, 6 Type 2 and 1 Type 3) 1 patient: 3D CEUS identified 1a and 2b  neck ballooned  1a resolved

  8. Endoleak on angiogram V 3D CEUS

  9. Results All renal arteries were patent on completion angio and 3D CEUS No endograft deformity Flow characteristics quantified by duplex in all cases

  10. EVAR in patients with CKD 2 patients with CKD IV underwent EVAR using CO2 angiography and 3D CEUS 1 patient – no iodinated contrast 1 patient – 5ml contrast Full completion imaging No reduction in GFR

  11. Completion CO2 angiogram & 3D CEUS

  12. Discussion 3D CEUS identifies and characterises endoleak following stent graft deployment Alternative to completion angiography Allows quality control of EVAR with ultra-low or no iodinated contrast

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