Muhammad Naeem Afzal, Shabbar Hussain Changazi, Muhammad Umar Warraich, Usman Ismat Butt, Samiullah Bhatti, Mustansar Iqbal.
To determine the frequency of concordance between Duplex ultrasound scan and CT scan in detection of endo-leak in patients following EVAR.
Esculapio J Services Inst Med Sci Jan ;15(2):147-50.

Objective: Objective of the study was to determine the frequency of concordance between Duplex ultrasound scan and CT scan in detection of endo-leak in patients following EVAR. Methods: This retrospective, descriptive study was conducted at Department of Vascular Surgery, Mater Misericordiae University Hospital Dublin, Ireland. The study was conducted from14thJuly, 2014 to13th July, 2016. Age range 50-70 years were included in the study. All patients who had Endovascular Aneurysm repair (EVAR) were followed up in six months` time using Duplex ultrasound scan and Computerized Tomography (CT). The detection of endo-leak on Duplex ultrasound scan and confirmed by Computerized Tomography (CT).The concordance between the two investigations was estimated by calculating the overall percentage of agreement (concordance) and the ? coefficient. The follow up imaging results were collected by using PACS (Picture archiving and communication system). All the data entered and analyzed using computer software SPSS version 17. Mean and standard deviation was calculated for quantitative variables like Age and BMI. Frequency and percentages were calculated for qualitative variables like gender, co morbidities like hypertension, DM, smoking status and concordance. Effect modifiers gender, BMI and co morbidities DM and HTN were controlled by stratification of data Results: Total 113 patients were enrolled in this study. In the study, mean age was 68yeatrs with the standard deviation of 3.09. 70.8% of patients were males and 29.2% were females. 46.9% of patients had BMI of 26-30 BMI and 34.5% had BMI >30. Among the total patients, 64.6% patients were diabetic, 77% hypertensive and 88.5% patients were smokers. 70.8% of endo-leaks were diagnosed by Duplex ultra-sound scan, while 77.8% of endo-leaks were diagnosed by CT scan. Cohens kappa value is 0.91 which shows strong association. Concordance between Duplex ultra-sound scan and CT scan calculated as 95.6%. Conclusions: This study concluded that Duplex ultra-sound scan can safely replace CT scan as a surveillance modality. Duplex ultra-sound scan can be used as a primary long-term surveillance imaging modality for patients with post EVAR and it will be more economical for patients without any loss of scan accuracy.

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