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. 2017 Jun 9;2017(6):CD010296. doi: 10.1002/14651858.CD010296.pub2

Badri 2010.

Clinical features and settings People with AAA who underwent EVAR between April 1998 and December 2007. During this period, 93 procedures performed but complete records unavailable in 34 participants.
Type of stents received: Cook‐Zenith (William A Cook, Australia; 54 participants), Talent Medtronic (Medtronic, UK) aortic stent graft (5 participants).
Aneurysm diameter: not reported.
Setting: Department of Vascular Surgery.
Participants 59 participants; 50 males; mean age: 79 years.
Comorbidities: not reported.
Geography: UK.
Study design Retrospective design; participants identified retrospectively based on availability of complete records ("93 procedures were performed but complete records were unavailable in 34 patients").
Target condition and reference standard(s) Target condition: endoleak.
Definition of endoleak: not reported.
Endoleak (absolute n): 14.
Prevalence of endoleak: 11.8% (37/314).
Reference standard: CTA (dual‐phase multidetector CT).
Type of CT scanner: Philips MX80000 IDT or GE Prospeed SX.
Image acquisition for Philips MX80000 IDT:
  • arterial and delayed phase acquisitions to cover the stent, 3D multiple rotational projections and sagittal and coronal views;

  • thickness: 5‐mm slice, pitch 1;

  • use of contrast: 120 mL of Iohexol (Omnipaque, GE Healthcare, Milwaukee, WI, USA) IV contrast given at 3 mL/s, with bolus tracking to determine timing of arterial phase, and delayed phase acquisition performed 60 s after.


Image acquisition for GE Prospeed SX:
  • arterial and delayed phase acquisitions to cover the stent; 3D multiple rotational projections and sagittal and coronal views;

  • thickness: 3‐mm slice, pitch 1.5;

  • use of contrast: 120 mL Iohexol (Omnipaque, GE Healthcare, Milwaukee, WI, USA) IV contrast given at 3 mL/s with arterial phase timing at 20‐25 s and delayed acquisition at 60 s.

Index and comparator tests Index test: DUS (2‐to 5‐MHz transducer, Philips IU22 scanner).
Image production: anterior posterior and transverse aortic sac diameters measured in transverse and longitudinal section. Pulsed Doppler used to evaluate any colour Doppler signals exterior to graft.
Type of US: 2‐ to 5‐MHz transducer (Philips IU22 scanner).
Use of contrast: no.
Operator: registered vascular technologist and board‐certified vascular surgeon.
Follow‐up 1, 3, 6, 12, and 18 months, and then yearly afterward (total of 314 paired scans obtained over a follow‐up period from 3 days to 9 years); no apparent loss to follow‐up or missing data.
Notes Other endpoints: sac size: anterior posterior, transverse, and maximum diameter (Dmax); graft patency.
Table of Methodological Quality
Item Authors' judgement Description
Representative spectrum? 
 All tests Yes Although enrolled people with AAA who underwent EVAR, they were retrospectively studied and from 93 procedures performed complete records were available for only 59 participants.
Acceptable reference standard? 
 All tests Yes CTA (dual‐phase multi‐detector CT on a Philips MX80000 IDT or GE Prospeed SX).
Acceptable delay between tests? 
 All tests Yes "Three hundred and fourteen paired scans were studied. Paired scans and almost all scans took place on the same day. Single scans outside this timeframe were excluded."
Partial verification avoided? 
 All tests Yes All study participants accounted for and results of reference standard reported for all.
Differential verification avoided? 
 All tests Yes All participants who received US subjected to CT scan.
Incorporation avoided? 
 All tests Yes Index test not part of reference standard.
Reference standard results blinded? 
 All tests Unclear "Two consultant interventional radiologists reported the CTA studies and 3 specialist vascular ultrasonographers performed and reported the DUS."
Index test results blinded? 
 All tests Unclear "Two consultant interventional radiologists reported the CTA studies and 3 specialist vascular ultrasonographers performed and reported the DUS."
Relevant clinical information? 
 All tests Yes Yes.
Uninterpretable results reported? 
 All tests Yes All data interpreted.
Withdrawals explained? 
 All tests Yes No apparent withdrawal occurred.