Diagnostic Colour Duplex Ultrasound for Type IIIb Endoleak

This report presents the treatment of an aortic endovascular aneurysm repair (EVAR) device failure, focusing on the use of colour duplex ultrasound (CDUS) to diagnose and confirm effective treatment of a type IIIb endoleak.

An 89 year old man with a history of EVAR was transferred to the authors' centre with complaints of abdominal pain and a pressure sensation behind the umbilicus. A previously stable 11 cm aneurysm sac was visualised on computed tomography angiography in addition to a newly suspected type IIIb endoleak, which was confirmed via CDUS. He underwent successful endovascular repair with a stent across the limb defect. The patient was discharged uneventfully and was followed for surveillance.

Type IIIb endoleak is an underreported complication after EVAR. CDUS of type IIIb endoleak aided in localisation and characterisation of the graft failure, and confirmed successful endovascular treatment of the endoleak defect in the side limb. Locating the point of graft failure using CDUS preceding endovascular repair of type IIIb endoleaks guides interventions and repair outcomes. It is a rare opportunity to report a case of acute type IIIb endoleak with CDUS that definitively localised an endograft defect.