The treatment of Aortic Aneurysm disease is a growing procedure due to increase of life expectancy in Western Countries and
relative incidence. In the past ten years we observed a progressive growth of endovascular over open surgery procedures with a related
decline in rupture related deaths. Endo Vascular Aortic Repair [EVAR] is a well known technique of treatment of abdominal aortic aneurysms,
that has changed the surgical approach to abdominal aortic aneurysms, as it is performed with low perioperative morbility and
mortality rate and shorter hospital stay. However although EVAR offers immediate advantages over open surgical repair, it carries the
need of close lifelong surveillance due to specific possible complications including rupture, endoleaks, graft migration and enlargement
of aneurysm sac size. Contrast Enhanced Computed Tomography [CTA] is actually considered the standard reference in EVAR followup.
However CTA carries high costs, radiation exposure and potential renal impairment. In the last five years several studies have been
published on the role of Contrast Enhanced UltraSound [CEUS] in EVAR follow-up asserting high accuracy of this evaluation technique
with absence of renal impairment, without radiation risk and at low costs. Especially since introduction of second generation Contrast
Agents this evaluation technique is gaining popularity in EVAR follow-up surveillance. The diffusion of CEUS investigations by using
new generation of contrast medium with appropriate software represents without any doubt an important step in the EVAR surveillance
and could open up new strategies in the evaluation of endovascular aortic procedures gaining a fundamental role in EVAR follow-up.