Contrast-enhanced Ultrasound for Endovascular Grafting in Infrarenal Abdominal Aortic Aneurysm in a Single Patient with Risk Factors for the Use of Iodinated Contrast

Renal insufficiency and allergic reactions to contrast media are potential contraindications to angiography with conventional ionic iodinated contrast media in endovascular stent-graft placement. Real-time contrast medium-enhanced ultrasonographic (US) guidance of endovascular aortic repair might provide an alternative to overcome these limitations. The authors report on endovascular aortic repair in a patient with an asymptomatic infrarenal aortic aneurysm and renal insufficiency. The precise placement of the stent-graft was performed solely with contrast-enhanced US and intraprocedural angiographic fluoroscopy without the use of any nephrotoxic contrast media. At follow-up, contrast-enhanced US was used to exclude endoleaks and stent-graft failure or malposition.