Evar Follow up based upon simplified protocol for Zenith at Veith meeting

Tim Chuter MD presented an interesting talk this afternoon looking at EVAR follow up. The talk was followed by a similar presentation by Mike Makaroun from Pittsburgh. The background is that the FDA available aortic endografts have various recommended protocols for post operative follow up. All involve computed tomography of the abdomen and pelvis at some interval. Usually a baseline study at one month after implantation followed by CT scan ranging from one at 1year post implant to an aggressive regimen of imaging at 6 mo. 

This protocol involves significant radiation exposure to the patient as well as significant cost to our health care system. Tim Chuter introduced an alternative protocol of baseline CT and KUB at one month. With no endoleak and no clinical suspicions based upon anatomy, he follows up with KUB and ultrasound at one year. The problem is that this protocol requires a good vascular lab and the studies all need to be performed by the same lab, ie technically dependent.

The summary conclusion is that selective imaging of the post EVAR patient may permit a decrease in the use of CT scanning with no detriment to patient care and a significant overall cost savings.

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