Contrast-enhanced ultrasound (CEUS) for EVAR surveillance
Type
ModificationConfidence
92%
Created
Apr 14, 2026
Evidence
1 source
Rationale
The existing citation Wanhainen A, et al refers to the 2019 ESVS AAA guidelines. The 2024 ESVS Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms (PMID 38307694) directly supersedes this for the same claim regarding CEUS utility in EVAR surveillance. Per the stale guideline replacement instructions, the 2019 citation has been replaced with the 2024 guideline rather than co-cited, as both support the same claim and there is no distinct historical context requiring retention of the older reference. The remainder of the section content is preserved unchanged.
Evidence
Content Changes
**Contrast-Enhanced Ultrasound (CEUS) for endovascular aneurysm repair (EVAR) Surveillance** Contrast-enhanced ultrasound utilizes intravenous microbubble contrast agents to enhance ultrasound signal and improve visualization of blood flow. In the context of EVAR surveillance, CEUS demonstrates high sensitivity for detecting endoleaks, particularly type II endoleaks that may be subtle on conventional imaging. CEUS serves as a valuable adjunct to computed tomography angiography (CTA) in EVAR surveillance protocols, offering several advantages including lack of ionizing radiation and use of non-nephrotoxic contrast agents. This makes CEUS particularly useful in patients with renal insufficiency or those requiring frequent surveillance imaging, where cumulative radiation exposure and contrast load are concerns. The role of CEUS in EVAR surveillance is outlined in major abdominal aortic aneurysm (AAA) guideline recommendations, which recognize its utility in selected patient populations. [@esvs2019-aaa][@esvs2024-editors] [@evar2019]
Reviewer Notes
Approved after replacement-first stale-guideline regeneration review. Clean same-family replacement of stale guideline citation with the known 2024 ESVS AAA superseding guideline.