Diagnosis and management of endoleak after endovascular repair of abdominal aortic aneurysm

Objective: To determine the diagnosis and management of endoleak after endovascular repair of abdominal aortic aneurysm (AAA).

Methods: We analysed retrospectively the data of 37 cases of infrarenal AAA treated by endovascular repair and investigated the reasons, managements, results and prognosis of endoleaks.

Results: Of 13 patients with endoleak at stent-graft deployment, 6 developed type I endoleak, 3 type II endoleak, 2 type III endoleak, 1 type IV endoleak, and 1 unknown reason. Type I and III endoleaks disappeared after management with additional techniques. The primary endoleak rate was 13.5%(5/37). Three sealed endoleak, 2 persistent endoleaks and 2 secondary endoleaks were found during follow up. The late endoleak rate was 10.8% (4/37).

Conclusions: Endoleak is a chief complication after endovascular repair of infrarenal AAA. The influencing factors for endoleak include neck morphology, distance, angulation, calcification, stent-graft selection and side branching arteries. Additional procedure and follow up are very important. Techniques to find endoleak include CTA, Duplex and MRA after operation. Endoleak with enlarged aneurysm should be treated actively.