Ann Surg Treat Res.  2014 Feb;86(2):95-99. 10.4174/astr.2014.86.2.95.

Clinical significance of type I endoleak on completion angiography

• Kim SM
• Ra HD
• Min SI
• Jae HJ
• Ha J
• Min SK

• KMID: 1908504
• DOI: http://doi.org/10.4174/astr.2014.86.2.95

Abstract

PURPOSE
Type I endoleak is known to be associated with sac enlargement and occasional rupture, therefore, the treatment of type I endoleak is recommended at the time of diagnosis. The aim of this study was to identify the significance of early type I endoleak found on completion angiography.
METHODS
Between January 2000 and December 2012, a total of 86 patients underwent endovascular abdominal aortic aneurysm repair (EVAR) and 10 patients (11.6%) were diagnosed with type Ia endoleak on completion angiography. Clinical and radiologic data were reviewed retrospectively.
RESULTS
Of the 10 patients, two underwent EVAR with custom-made stent-grafts in the initial stage and both of them needed immediate treatment: one case involved open repair while the other involved insertion of an additional stent-graft. In 8 patients, the amount of leakage decreased after repeated balloon molding. They were managed conservatively and followed up with computed tomography angiography within 2 weeks after EVAR. In 7 of the 8 cases, type Ia endoleaks disappeared. In one patient with a persistent endoleak and a folded posterior wall of the stent-graft, coil embolization was performed 1 week after EVAR. With a median follow-up of 12 months (range, 1-61 months), no patients showed recurrence of type I endoleak or sac expansion.
CONCLUSION
Type I endoleaks diagnosed on completion angiography sealed spontaneously in 7 of 10 patients (70.0%). In cases of decreased amounts of leakage after balloon molding, simple observation may be an alternative to repetitive procedures. The long-term follow-up of patients with self-sealed type I endoleaks is mandatory.

Keyword

Endovascular aneurysm repair; Abdominal aortic aneurysm; Endoleak

MeSH Terms

Angiography*
Aortic Aneurysm, Abdominal
Diagnosis
Embolization, Therapeutic
Endoleak*
Follow-Up Studies
Fungi
Humans
Recurrence
Retrospective Studies
Rupture

Figure

• 

  Fig. 1 (A-C) Computed tomography angiography demonstrating type I endoleak with posterior wall of stent-graft folded (arrows).

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  Fig. 2 (A-C) Fluoroscopic image demonstrating selective catheterization of the type Ia endoleak and deployment of coils into the space.

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