PostEVAR CT A Lawsuit Risk if Pathology Missed

By Bruce Jancin

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ROME -- Unexpected and potentially serious incidental pathology was seen on the follow-up CT scans of 38% of patients who had endovascular repair of abdominal aortic aneurysm in a large, retrospective, single-center review, Dr. Helen Ballal reported at the annual meeting of the Cardiovascular and Radiological Interventional Society of Europe.

In follow-up CT exams, attention is typically focused on how the aneurysm repair is doing. If the examiners happen to miss, say, a tumor in a distant corner of the scan, or note it in passing but fail to follow up appropriately, they may find themselves defendants in a negligence lawsuit, said Dr. Ballal of Royal Liverpool (England) University Hospital. She reported on 233 consecutive patients who had a median of four CT scans during 34 months of follow-up after endovascular aneurysm repair.

Overall, 54% of patients had simple, benign incidental pathology. But 30% had benign features with greater potential significance warranting added review. Pathologies were seen in virtually every organ system, including renal, pulmonary, cardiac, urologic, hepatic, and skeletal. Of greatest concern, 8% of patients had suspected malignancies on a follow-up CT scan, all of which were confirmed to be cancer. None were present on preprocedural imaging.

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