➤ The SVS recommends DUS and non-contrast-enhanced CT scanning
as alternative imaging surveillance after EVAR in patients with
contraindications to iodinated contrast agents. (1-B)
➤ The SVS recommends total aortic imaging with non-contrast-enhanced
CT scanning at 5-year intervals after open surgical repair or EVAR to
detect aneurysmal degeneration of other aortic segments. (1-C)
Mesenteric Arteries
➤ There are no prospective reports documenting the efficacy of a
surveillance protocol after mesenteric artery stenting or bypass grafts.
However, recurrent mesenteric ischemia is potentially life-threatening.
Therefore, after mesenteric artery (celiac, superior mesenteric, and
inferior mesenteric) angioplasty with or without stenting or mesenteric
artery bypass grafting, the SVS recommends the following (1-C):
• Clinical follow-up and baseline DUS within 1 month of the procedure.
• Clinical follow-up and DUS at 6 months, 12 months, and then annually thereafter.
➤ The SVS suggests contrast imaging for patients with symptoms of
recurrent mesenteric ischemia after mesenteric artery stents or bypass
grafts or for the following DUS findings (2-C):
• Celiac axis: PSV >370 cm/s or a substantial increase from the post-treatment baseline
PSV.*
• Superior mesenteric artery: PSV >420 cm/s or a substantial increase from the post-
treatment baseline PSV.*
• Inferior mesenteric artery: Substantial increase from the post-treatment baseline
PSV.*
Renal Arteries
➤ There are no prospective reports documenting the efficacy of a
surveillance protocol after renal artery interventions. After renal
artery angioplasty with or without stenting or renal artery bypass or
endarterectomy, the SVS suggests the following (2-C):
• Clinical follow-up and baseline DUS within 1 month of the procedure.
• Clinical follow-up and DUS at 6 months and 12 months and then annually
thereafter.
➤ The SVS suggests contrast-enhanced imaging for loss of renal
parenchyma (a decrease in kidney length of >1 cm) or for the following
DUS findings (2-B):
• Renal artery: PSV ≥280 cm/s or a substantial increase from the post-treatment
baseline PSV.*
• Renal to aortic velocity ratio of ≥4.5.
* What constitutes a substantial increase has not been defined.
