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Arch Surg. 2008;143(4):424.

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Answer: Endoleak

The CT scan depicts an endoleak, which is persistent filling of contrast into the aneurysm sac after stent graft exclusion. They are classified into 5 types. Type I refers to a leak across the seal zone either proximally or distally. Type I leaks are usually seen at placement or years later after migration of the proximal attachment. If seen during initial placement, they should be treated prior to terminating the operation because they rarely spontaneously resolve.

Type II endoleaks are due to retrograde flow through branch vessels, which are either lumbar arteries or the inferior mesenteric artery (IMA). They occur in approximately 20% of patients after endovascular stent graft repair of abdominal aortic aneurysm.¹ Type II endoleaks are typically followed with serial CT scans, and many are seen to close spontaneously. Some surgeons will treat if the endoleak persists for greater than 6 months, some will treat for growth in . . . [Full Text of this Article]

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Arch Surg. 2008;143(4):423.
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