Successful endovascular treatment of femoro-popliteal aneurysm and sonographic follow-up with B-Flow™: a case report

Authors

  • Mathias Kaspar Vasacura Gefässpraxis am Schlossberg, 3400 Burgdorf, Switzerland , Angiologie, STS Spital Ag Thun, 3600 Thun, Switzerland , Spital STS image/svg+xml
  • Suzana Doric Balgrist University Hospital, University of Zurich, Zurich, Switzerland
  • André Wyss Radiologie, STS Spital Ag Thun, 3600 Thun, Switzerland , Spital STS image/svg+xml
  • Jörn Fredrik Dopheide Vasacura Gefässpraxis am Schlossberg, 3400 Burgdorf, Switzerland; Angiologie, Spital STS AG Thun, 3600 Thun, Switzerland; Universität Bern, 3010 Bern, Switzerland; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), 6900 Feldkirch, Austria , University of Bern image/svg+xml , Vorarlberg Institute for Vascular Investigation and Treatment image/svg+xml , Spital STS image/svg+xml https://orcid.org/0000-0003-3365-8338

DOI:

https://doi.org/10.59667/sjoranm.v30i2.16

Keywords:

endovascular aneurysm repair, peripheral vascular aneurysm, contrast enhanced ultrasound (CEUS), endoleak detection, B-Flow™, ultrasound surveillance

Abstract

Introduction:
Endovascular repair is an option for selected patients with femoro-popliteal aneurysms. Follow-up assesses graft patency, aneurysm size and possible endoleaks. B-Flow™ provides contrast-free blood-flow imaging, but its role in surveillance after peripheral aneurysm repair remains insufficiently validated.

Case report:
A 77-year-old man with bilateral femoro-popliteal aneurysms declined further open surgery after early occlusion of a right-leg bypass and postoperative lymphedema. Following endovascular recanalization of the right-leg bypass, the left femoro-popliteal aneurysms were treated with two 10 × 150 mm GORE Viabahn™ endoprostheses. A small endoleak was visible on completion angiography. No endoleak was detected by B-Flow™ or contrast-enhanced ultrasound (CEUS) at 24 hours or at 3, 12 and 24 months. Computed tomography angiography (CTA) at 6 months showed patent endografts without an endoleak. Fontaine stage IIb symptoms improved to stage I. Primary patency was maintained through 24 months.

Discussion:
In this patient, B-Flow™ findings were consistent with CEUS findings during follow-up. This observation does not establish diagnostic accuracy, non-inferiority or the ability of B-Flow™ alone to exclude endoleaks. Early postimplantation shadowing limited visualization of intragraft flow.

Conclusion:
This case illustrates endovascular repair and multimodal surveillance of femoro-popliteal aneurysms over 24 months. B-Flow™ may offer complementary contrast-free imaging. Further studies are required before recommending it as a replacement for established surveillance methods.

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Published

2026-05-30

Data Availability Statement

The data may be requested from the corresponding author at joern.dopheide@spitalstsag.ch, subject to applicable consent and privacy requirements.

Issue

Vol. 30 No. 2 (2026)

Section

Case reports

License

Copyright (c) 2026 Mathias Kaspar, Suzana Doric, André Wyss, Jörn Fredrik Dopheide

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

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How to Cite

Kaspar, M., Doric, S., Wyss, A., & Dopheide, J. F. (2026). Successful endovascular treatment of femoro-popliteal aneurysm and sonographic follow-up with B-Flow™: a case report. Swiss Journal of Radiology and Nuclear Medicine, 30(2), 12-21. https://doi.org/10.59667/sjoranm.v30i2.16

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