Endoleak - types of endoleaks after endovascular aneurysm repair (EVAR)
The term "endoleak" was proposed in 1996 by White et al. in a letter to editor, where the authors described its basic types. It refers to a failure of endovascular aneurysm repair (EVAR) with persistent blood flow within an aneurysm sac but outside the lumen of the endoluminal graft. Persistent endoleak causes continued pressurization of the aneurysm with the risk of its rupture as a consequence.
| Type | Subtype | Description |
|---|---|---|
| Type I | insufficient seal at the site of graft attachment - at proximal or distal end, or at overlap of components | |
| Ia | around the proximal end of the body of stentgraft | |
| Ib | around the distal end of the body of stentgraft | |
| Ic | around the distal end of the iliac component | |
| Type II | perfusion of the aneurysm sac via branch or collateral vessels | |
| IIa | single vessel | |
| IIb | ≥2 vessels | |
| Type III | endoleak throught a defect in the stentgraft or inadequate sealing of overlapping stentgraft components | |
| IIIa | junctional separation of overlapping stentgraft components | |
| IIIb | defect in the stentgraft - fracture of the stentgraft or rupture of the graft fabric | |
| Type IV | leak through the stentgraft fabric due to its porosity | |
| Type V | endotension - expansion of the aneurysm continues despite no evidence of leak on imaging |
References:
1. White GH, Yu W, May J. Endoleak--a proposed new terminology to describe incomplete aneurysm exclusion by an endoluminal graft. J Endovasc Surg. 1996 Feb;3(1):124–5.
2. Cao P, De Rango P, Verzini F, Parlani G. Endoleak after endovascular aortic repair: classification, diagnosis and management following endovascular thoracic and abdominal aortic repair. J Cardiovasc Surg (Torino). 2010 Feb;51(1):53–69.