ELIIEarlham/Lilly Indiana Initiative (Earlham College; Richmond, IN)
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In 10 (47.6%) patients, considered at high risk of ELII due to the presence of the morphological risk factors cited before [16], a 45 cm long 5 F Terumo_ Destination sheath was introduced over the wire, parallel to the contralateral limb and advanced under fluoroscopy to the AAA-sac.
One (5%) and seven (33%) low-flow-endoleaks (ELII) were detected by ICM-A and C[O.sub.2]-A (Figures 2(a), 2(b), 2(c), 3(a), and 3(b)), respectively.
Three ELII detected by C[O.sub.2]-A were not detected by CEUS.
CEUS and ICM-A showed a poor agreement for ELII detection (Cohen's K: 0.35).
While C[O.sub.2]-A allowed us to detect 7 ELII, only one of them was seen at ICM-A.
The diagnostic accuracy of C[O.sub.2] in ELII detection is debated in the literature.
Finally, ELII are visualized faster by C[O.sub.2]-A than by ICM-A due to the lower viscosity [11] and this could reduce the radiation time exposure for both patient and operator.
We interpreted them as very low-flow ELII, sealed within the first postoperative day, before the evaluation by CEUS.
(b)Carbon dioxide completion angiography that shows the good positioning of the infrarenal fixation endograft and the presence of ELII. (c) Magnification of ELII from sacral artery (red arrows indicates ELII coming from sacral artery).