Describe and illustrate the imaging findings of endoleaks following endovascular abdominal aortic aneurysm repair (EVAR) Remind the classification of endoleaks and the level of urgency for their treatment Describe the possible procedures for managing endoleaks

Endovascular Aneurysm Repair (EVAR) Endovascular aneurysm repair with stent-graft placement is a rising endovascular treatment option for abdominal aorta aneurysms. It consists on placement of a stent-graft for the "total exclusion" of the aneurysm. However this total exclusion sometimes fails because of an endoleak of blood flow to the aneurysm lumen, which is the main cause of complications and failure of the EVAR. When an endoleak happens, it causes continued pressurization of the aneurysm sac, with risk of aneurysm rupture. Advantages and disadvantages: The advantages...

Embolization: Type II endoleaks Fig. 21 are usually managed by transarterial approach: a) Transarterial approach: a catheter is placed in the vessel of origin (in this case, the superior mesenteric artery) Fig. 22 Fig. 23 Microcatheters are pulled through collateral vessels into the vessel that communicates with the aneurysm sac (in this case the inferior mesenteric artery) [Haulon S, J Vasc Surg 2001] Metallic coils are then used to embolize the vessel near its communication with the aneurysm sac to block the leak Fig. 24...

- Patients undergoing EVAR require lifelong imaging surveillance to detect complications, mainly endoleaks. - Endoleaks are one of the most common complications of EVAR, and may be classified in 5 types. - After an endoleak has been detected, it is important to determine (mainly by angiography) the type of endoleak we are dealing with, as each particular endoleak type has a different risk of rupture in the short term. - Treatment of endoleaks may be urgent in cases of high-pressure endoleaks (as type I and...

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