Endovascular aneurysm repair (EVAR) offers many patients a minimally invasive option to address vascular pathologies like aortic aneurysm. By deploying a fabric-covered stent within the aneurysm, blood is rerouted through this conduit thereby excluding the aneurysm sac and preventing further dilation of the aorta. An endoleak occurs when blood flow persists within the aneurysm sac after EVAR.
Several types of endoleaks are recognized by the Society for Vascular Surgery:
Type 1a: proximal stent attachment site
Type 1b: distal stent attachment site
Type II: most common, backfilling of the aneurysm from branch vessels
Type III: misalignment or defect of graft materials
Type IV: leak through porous graft material
Type V (“endotension”): enlargement of aneurysm with no evidence of leak
Repairs can range from re-expansion of the graft using balloon dilation, additional graft extension, embolization of culprit vessels (type II), periodic surveillance, etc.
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