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Intravascular ultrasound (IVUS) in endovascular abdominal aortic aneurysm repair — an adjunctive imaging tool or even less invasive self-guidance method?

Joanna Elżbieta Kobak12, Weronika Wallach3, Aleksander Oskroba3, Martyna Janczewska4, Ewelina Mączka3, Jan Kęsik12, Grzegorz Borowski12, Tomasz Zubilewicz12, Piotr Terlecki12, Stanisław Przywara12

Abstract

Endovascular aneurysm repair (EVAR) is a minimally invasive technique alternative to conventional open surgical
aneurysm repair. Nowadays, the majority of abdominal aortic aneurysms (AAAs) with suitable anatomy are
primarily treated using EVAR; however, conventional EVAR procedure is associated with the necessity of contrast
agent administration and exposure to ionizing radiation, which carries a risk not only for patients but also for
the surgical team. Furthermore, the EVAR procedure may be unfeasible for patients with renal insufficiency
and other contraindications to intravascular contrast agent administration, i.e. contrast allergy. An even less
invasive guidance method for EVAR procedures seems to be intravascular ultrasound (IVUS), which may abolish
the risk associated with contrast media usage and radiation exposure. The literature review concerns the latest
research about IVUS guidance during EVAR to establish the current application of this imaging modality in daily
clinical practice, its efficiency, advantages and drawbacks.

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