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[The problem with endoleakage in endoluminal therapy].
1Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauss Allee 11, 93053 Regensburg. johann.link@klinik.uni-regensburg.de
Der Radiologe
|September 13, 2001
Summary
Endovascular repair of aortic aneurysms can lead to endoleaks, a frequent complication. Persistent endoleaks increase rupture risk, necessitating timely diagnosis and treatment with imaging and interventions.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Medical Imaging
Background:
- Endovascular aneurysm repair (EVAR) using stent grafts is increasingly common.
- Endoleaks are the most frequent complication following EVAR.
- Persistent endoleaks can lead to aneurysm enlargement and rupture.
Purpose of the Study:
- To review the diagnosis and management of endoleaks after EVAR.
- To discuss the role of imaging modalities and interventional techniques.
- To highlight the importance of treating persistent endoleaks.
Main Methods:
- Review of diagnostic tools including spiral computed tomography (CT) and angiography.
- Discussion of treatment strategies for different endoleak types (Type I, II, III).
- Analysis of outcomes and secondary intervention rates.
Main Results:
- Spiral CT with biphasic acquisition is the most sensitive diagnostic method for endoleaks.
- Selective angiography correctly identifies inflow/outflow in 86% of cases.
- Secondary interventions were required in nearly 10% annually (Eurostar study).
Conclusions:
- Perigraft endoleaks require treatment.
- Patent side branches are observed for 6 months; embolization is indicated if aneurysm morphology changes.
- Treatment strategies vary by endoleak type, with additional stent-graft placement or coil embolization being common.