Authors' objectives: An abdominal aortic aneurysm is a swelling or bulge that causes the wall of the main blood vessel (aorta) to weaken and become pouched or sac-shaped. Large aneurysms can burst, causing massive internal bleeding, which can lead to death. Endovascular aneurysm repair (EVAR) of the aneurysm is minimally invasive but it is associated with potential complications. The most common complication is the occurrence of an endoleak (blood flow in the aneurysm sac). Consequently, patients who receive EVAR treatment must be followed-up for the rest of their life. Computed tomography angiography (CTA) is an imaging modality widely used for the surveillance after EVAR. CTA is considered to be very accurate but it is not very good at detecting the direction of blood flow from an endoleak. It also carries the risk of repeated exposure to radiation and to a toxic contrast agent. Colour duplex ultrasound (CDU) and contrast enhanced ultrasound (CEU) have been suggested as possible, safer, imaging alternatives to CTA but have not been widely adopted. The optimal surveillance strategy with regard to the choice of imaging modalities and the frequency of testing has not been established yet. The purpose of this appraisal is to perform a literature search to assess the current evidence for the clinical effectiveness and cost-effectiveness of surveillance strategies using colour duplex and contrast-enhanced ultrasound compared with CTA in the surveillance after EVAR. Where possible we will include data from national and international clinical registries and databases. The results of the project will be used by the National Institute for Health and Care Excellence (NICE) to issue clinical guidance in England and Wales on the optimal surveillance strategy after EVAR.

Project Status: Completed

URL for project: http://www.nets.nihr.ac.uk/projects/hta/157801

Year Published: 2018

URL for published report: https://www.journalslibrary.nihr.ac.uk/programmes/hta/157801#/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

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