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. 2014 Feb;86(2):95-9.
doi: 10.4174/astr.2014.86.2.95. Epub 2014 Jan 22.

Clinical significance of type I endoleak on completion angiography

Suh Min Kim  1 , Hwan Do Ra  1 , Sang-Il Min  1 , Hwan Jun Jae  2 , Jongwon Ha  1 , Seung-Kee Min  1
Affiliations

Clinical significance of type I endoleak on completion angiography

Suh Min Kim et al. Ann Surg Treat Res. 2014 Feb.

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.

Keywords: Abdominal aortic aneurysm; Endoleak; Endovascular aneurysm repair.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
(A-C) Computed tomography angiography demonstrating type I endoleak with posterior wall of stent-graft folded (arrows).
Fig. 2
Fig. 2
(A-C) Fluoroscopic image demonstrating selective catheterization of the type Ia endoleak and deployment of coils into the space.
See this image and copyright information in PMC

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