What are the types of endoleaks?

What are the types of endoleaks?

Classification

• type I: leak at graft ends (inadequate seal) – most common after repair of thoracic aortic aneurysms 4
• type II: sac filling via branch vessel (e.g. lumbar or inferior mesenteric artery)
• type III: leak through a defect in graft fabric (mechanical failure of graft)

Are endoleaks common?

Type II endoleak: Type II endoleaks are the most common. These are leaks that happen when blood flows into the aneurysm sac from branches of the aorta, or other blood vessel treated with a stent.

What is an endograft?

A device known as an endoluminal stent graft (or endograft) can be placed inside the thoracic portion of the aorta to provide support for the weakened artery. This endograft is a hollow, fabric-covered tube, surrounding a mesh metal cylinder (or stent).

How do you detect endoleak?

Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour duplex ultrasound (CDUS) and contrast‐enhanced CDUS (CE‐CDUS) are less invasive but considered less accurate than CT.

How serious is an endoleak?

Occasionally, blood will still flow into the aneurysm sac even after a stent graft is in place; this flow, called an endoleak, can become potentially life threatening. Our interventional radiologists are specialists in endoleak repairs and treatment of the areas of the body in which the repairs take place.

What is a Type 4 endoleak?

Type IV endoleaks are a type of endoleak which usually occurs secondary to graft porosity and are typically seen in the immediate post operative angiogram following an endovascular aneurysm repair.

How do you treat Endoleaks?

Treatments

1. The most common approach is a translumber embolization.
2. Another common approach is transarterial embolization using microcatheter techniques.
3. Other less commonly used approaches include branch vessel ligation, transgraft embolization and open surgical conversion.

What causes Endoleaks?

Endoleaks occur when blood leaks back into an aneurysm sac following an endovascular aneurysm repair (EVAR) procedure—one of the procedure’s most common complications.

What is a fenestrated endograft?

Fenestrated and branched endografts are stents (small metal scaffolds or tubes) that have reinforced openings (fenestrations) or branches that allow the physician to attach arteries that lead to other organs.

How do you fix Endoleaks?

Treatments. A Type I endoleak is usually treated with an endovascular procedure to adjust endograft placement so that the “seal zone” shifts to a healthier segment of artery. In some cases, an embolization procedure is used to seal a Type I endoleak.

Which Endoleaks should be fixed?

Type I and type III endoleaks represent direct communication with the systemic blood flow and the aneurysm sac and require immediate repair.

What is a type 1b endoleak?

Type 1b endoleak is associated with an increased aortic tortuosity index (>0.15 cm-1). No significant difference is found in relation to age and gender. Treatment is required in most cases (22/27) and is usually performed with distal extension of the stent graft (21/27).