Abstract
Continued perfusion of an abdominal aortic aneurysm (AAA) after endovascular stent-graft deployment has been termed an “endoleak.”
There are five types of endoleaks:
Type I: inadequate seal at the proximal or distal attachment sites.
Type II: continued blood flow through a patent inferior mesenteric artery (IMA), lumbar artery or hypogastric artery. Requires an inflow and outflow artery. (Most common type of endoleak.)
Type III: midgraft leak from fabric holes or an inadequate seal between graft components.
Type IV: transgraft flow from porosity of the graft (usually takes place immediately after placement).
Type V: also known as endotension; aneurysm enlargement without an identifiable leak.[/l1]
Endoleaks contributing to continued perfusion of the aneurysmal sac can lead to enlargement and possibly rupture of the sac.
Treatment involves interrupting vessel flow and includes the use of coils, onyx (ethylene–vinyl alcohol) and thrombin ± gelfoam.
Embolization can be performed either at the time of EVAR or during a subsequent procedure.
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Johnson, S., Fraser, J., Gupta, R. (2010). Endoleaks Following EVAR. In: Kessel, D., Ray, C. (eds) Transcatheter Embolization and Therapy. Techniques in Interventional Radiology. Springer, London. https://doi.org/10.1007/978-1-84800-897-7_37
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DOI: https://doi.org/10.1007/978-1-84800-897-7_37
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