Can Color Doppler Ultrasound Be Effectively Used as the Follow-Up Modality in Patients Undergoing Splenic Artery Aneurysm Embolization? A Correlational Study between Doppler Ultrasound, Magnetic Resonance Angiography and Digital Subtraction Angiography

Krzysztof Lamparski, Grzegorz Procyk, Krzysztof Bartnik, Krzysztof Korzeniowski, Rafał Maciąg, Vadym Matsibora, Michał Sajdek, Alicja Dryjańska, Emilia Wnuk, Grzegorz Rosiak, Edyta Maj, Magdalena Januszewicz, Aleksandra Gąsecka, Tomasz Ostrowski, Piotr Kaszczewski, Zbigniew Gałązka, Mikołaj Wojtaszek

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Abstract

Splenic artery aneurysm (SAAs) rupture is associated with a high mortality rate. Regular surveillance with imaging before and after intervention is crucial to guide best evidence treatment. The following study aimed to determine the efficacy of color Doppler ultrasound imaging (DUS) compared to digital subtraction angiography (DSA) and magnetic resonance angiography (MRA) as a follow-up modality after selective coil embolization of true SAAs. We analyzed data from 20 patients, 15 females (48.1 ± 16.1 years) undergoing selective SAA coil embolization using detachable fibered embolization coils. Imaging using DUS, MRA, and DSA was performed 3 months after the initial embolization or the consequent re-embolization procedure. Primary clinical success, defined as Class I aneurysm occlusion, on 3-month follow-up was seen in 16 (80.0%) patients. DUS had a sensitivity of 94.4% and a specificity of 42.9% when compared to DSA and 92.3% and 30%, respectively, when compared to MRA in identifying Class I aneurysm occlusion. The positive predictive value (PPV) of DUS in identifying the need for re-embolization was 75.0%, while the NPV of DUS in these terms was 90.5%. DUS showed a high sensitivity in detecting aneurysm occlusion and clinical success, simultaneously exhibiting poor specificity. Still, with caution, this follow-up modality could be used for monitoring select low-risk patients after selective embolization of SAAs. DUS could provide a higher cost-to-benefit ratio, enabling more systematic post-procedural follow-up, as it is far more commonly used compared to MRA and non-invasive compared to DSA.
Original languageEnglish
Article number792
JournalJournal of clinical medicine
Volume12
Issue number3
DOIs
Publication statusPublished - 1 Feb 2023

Keywords

  • aneurysm coil embolization
  • aneurysm follow-up
  • aneurysm surveillance
  • color Doppler ultrasound
  • splenic artery aneurysm
  • visceral artery aneurysm

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