Page 297 - Libro 2

PART 5 • ABDOMINAL
18
Aorta and Iliac Arteries
Kathleen A. Carter and Jenifer F. Kidd
OBJECTIVES
Identify the characteristics of a complete aortoiliac duplex imaging exam
Define aortic and iliac aneurysms
Describe the importance of orthogonal orientation in the measurement of aneurysms
Identify three key characteristics that should be evaluated when assessing iliac stents
List three frequent complications associated with aortic endograft repair (EVAR)
List four types of endoleaks and their frequency
KEY TERMS
aneurysm | aortoiliac | aortoiliac disease | atherosclerosis | endoleak | endovascular aneurysm repair (EVAR) | fusiform | iliac stent | long-term surveillance | saccular
GLOSSARY
aneurysm a localized dilatation of the wall of an artery
endoleak the continued blood flow into an excluded aneurysm after endovascular placement of a stent graft
endovascular aneurysm repair a form of minimally invasive surgery in which a stent graft
Color duplex ultrasonography (CDU) can be an important modality for the diagnosis and postint- ervention follow-up of pathology in the aorta and iliac arteries. Ultrasound has been used for many years to detect and follow the presence of abdom- inal aortic aneurysm (AAA).1 The first use of ul- trasound to demonstrate the size of an AAA was reported in 1961 by Donald and Brown.2 Studies have also shown excellent correlation of ultrasound with arteriography in the detection of aortoiliac ath- erosclerotic disease.3,4 CDU provides both anatomic as well as physiologic information, is noninvasive,
is placed inside an aneurysm providing a new channel for blood flow and excluding flow from the dilated walls of an artery
fusiform elongated, spindle-shaped saccular a saclike or pouch-like bulging
stent a tubelike structure placed inside a blood vessel to provide patency and support
nontoxic, and well tolerated by patients. It allows the examiner to make both qualitative as well as quantitative assessment of blood flow using a com- bination of pulsed wave and color Doppler.
Ultrasound can rapidly differentiate aortic aneu- rysmal disease from tortuosity, adjacent visceral an- eurysms, or retroperitoneal lymphadenopathy.5 The incidence of AAA in the US population is 60/1,000.6 It is the 12th leading cause of death, with approxi- mately 15,000 deaths from ruptured aortic aneurysms in the US annually.7 AAA occurs with more frequency in older men and is found most often inferior to the
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