Strategy for Diagnosis and Treatment of Endoleak after EVAR at Early and Mid-term Follow-up

Abstract

The aim of this study was to evaluate a strategy for diagnosis and treatment of endoleak, after endovascular aneurysm repair (EVAR), for abdominal aortic aneurysm at early and mid-term follow-up. One hundred eighty one patients receiving MD-CT imaging more than 6 months after EVAR were enrolled in this study. Endoleak after EVAR was evaluated by intraoperative angiography and postoperative MD-CT. Type I/V endoleak developed in 6 patients (3.3%). Four patients received graft limb extension to the external iliac artery, which resulted in good sealing without aneurysmal expansion (greater than 5 mm). Type II endoleak developed in 30 cases (16.6%), and 5 cases (16.7%) showed aneurysmal expansion. Four cases underwent coil embolization through the ilio-lumbar artery. One patients suffered open conversion, but there was no aneurysm rupture in mid-term follow-up. We concluded that type II EL with aneurysmal expansion is not benign and should be carefully followed-up with CT imaging, and be treated by endovascular re-intervention.