A Pictorial Review of Current Approaches in Endoleak Imaging

Endoleak is a significant complication of endovascular aortic repair, associated with adverse long-term outcomes. This review discusses the classification, mechanisms, and imaging diagnosis of endoleaks. Five types of endoleaks are described, each with distinct characteristics and management approaches. Imaging modalities for endoleak detection include computed tomography, magnetic resonance imaging, ultrasonography, and angiography, each with unique advantages and limitations. Computed tomography remains the gold standard, but magnetic resonance imaging and contrast-enhanced ultrasound show promise in specific scenarios. The article details imaging findings for each endoleak type, emphasizing the importance of multimodality imaging for accurate diagnosis. While computed tomography is essential for early postoperative evaluation and reintervention planning, a tailored approach using various imaging techniques may optimize long-term surveillance. Future research should focus on establishing cost-effective, radiation-minimizing protocols for lifelong post-endovascular aortic repair monitoring.