Learning objectives
- To describe the classification of endoleaks and the diagnostic findings on imaging techniques.
- To describe the role of some imaging guided procedures in the management of some types of endoleaks
Background
Abdominal aortic aneurysm occurs when the diameter of the infrarenal aorta reaches 3.0 cm(Fig 1).
The risk of rupture is related with aneurysm size: approximately 5% per year for 5 cm diameter aneurysm and increases to 10% per year for 6 cm aneurysm and to 25% per year for aneurysm 7 cm or larger [1].
Endovascular aortic aneurysm repair was introduced in 1991 and has since been used widely in patients with aortic aneurysm to prevent aneurysm enlargement and rupture [1,
2].
A covered stent...
Imaging findings OR Procedure details
Endoleaks are diagnosed whencontrast material fills the excluded aneurysmal sac.
Imaging studies shouldbe able to define the endoleak and its cause. The imaging method of choice to detect,
classify and follow-up of endoleaks after endovascular aortic aneurysm repair is multidetector CT angiographywith multiplanar reconstructions (Fig 3) [5,
6,
7].
Digital subtraction angiography (DSA) is not a first line technique in diagnosing endoleaks butcould beused for characterization of type I leaks or in problematic cases,
as well as in the treatment of some types of leaks....
Conclusion
Endoleaks in aneurismal sac are the most frequent complication after endovascular aneurismal repair.
Understanding the endoleak classification is very important for the diagnosis and therapeutic planning of these patients.
References
(1) Macari M et al.
Abdominal aortic aneurysm: Can the arterial phase al CT evaluation after endovascular repair be eliminated to reduce radiation dose?.
Radiology.
2006 Dec; 241(3): 908-14.
(2) Stavropoulos S et al.
Imaging techniques for detection and management of endoleaks after endovascular aortic aneurysm repair.
Radiology.
2007 Jun; 243(3): 641-52.
(3) Schermerhorn M et al.
Endovascular vs.
Open repair of abdominal aortic aneurysm in the Medicare population.
New England Journal of Medicine 2008; 358:464-74.
(4) Toshifumi M et al.
Complications of endovascular repair...
Personal Information
Jimena Gonzalez Nieto.
3th year resident.
Radiology Department.
Clinico San carlos Hospital.
Madrid- Spain.
[email protected]
Cristina Batz Colvee.
3th year resident.
Radiology Department.
Clinico San carlos Hospital.
Madrid- Spain.
[email protected]
Manuel Moreu Gamazo.
4th year resident.
Radiology Department.
Clinico San carlos Hospital.
Madrid- Spain.
[email protected]
Javier Armijo Astrain.
Interventional vascular radiologist.
Radiology Department.Clinico San carlos Hospital.
Madrid- Spain.
[email protected]
Ramiro Mendez Fernandez.
Radiologist.Radiology Department.Clinico San carlos Hospital.
Madrid- Spain.
[email protected]