Basic Science Review: Characterization of Endoleak Following Endovascular Repair of Abdominal Aortic Aneurysms

Abstract

Aneurysm models have been developed to study the pathobiology of abdominal aortic aneurysm and to evaluate the efficacy of endovascular therapy. The purpose of this review is to describe the use and limitations of current animal and experimental models for the characterization of endoleak following endovascular repair of abdominal aortic aneurysms.

Endoleak management and postoperative surveillance following endovascular repair of internal carotid artery vascular diseases using Willis covered stent

“…According to the source of blood flow causing the leak, the endoleak-type intracranial aneurysms after deployment of the covered stent are classified as types I to IV. 7 , 8 Type I endoleaks result from blood flow that originates from the proximal (type Ia) or distal (type Ib) endograft attachment sites. Type II endoleaks represent retrograde blood flow through the branch artery at the membrane-covered area into the aneurysm sac.…”

“…The detection and management of endoleaks after endovascular repair of abdominal aortic aneurysms and thoracic aortic aneurysms have been documented. 7 , 8 , 9 , 10 , 11 , 12 However, no study has exclusively investigated endoleak management for endovascular repair of ICAVDs with covered stents. In the current study, we performed a retrospective analysis of endoleak management and postoperative surveillance following endovascular repair of ICAVDs treated with Willis covered stents in our institution to elucidate the outcomes and prognosis.…”

Endovascular Treatment of Complex Vascular Diseases of the Internal Carotid Artery Using the Willis Covered Stent: Preliminary Experience and Technical Considerations

“…Thus, endoleak has become a significant issue after using the covered stent. Generally, endoleak is caused by incomplete occlusion of the disease orifice after covered stent placement, which can be classified into types I-IV according to the source of blood flow (21,22). Type I endoleak, resulting from blood flow that originates from the proximal or distal endograft attachment sites, is the most common type.…”

A multimodality vascular imaging phantom of an abdominal aortic aneurysm with a visible thrombus

“…16 Furthermore, animal lesions do not adequately simulate the complex 3D anatomy and, in particular, the thrombus frequently observed in large human AAAs. 15 Also, the stent must often be downsized to fit animal vessels, which are smaller than human ones. 17 On the other hand, in vitro experimentations are very useful in the development phases of stent grafts and in improving implantation techniques.…”

“…12,13 Animal experimentations have also been relevant to human diseases by giving more detailed information on the healing process following EVAR and the genesis of endoleaks. 14,15 These animal models are expensive, difficult to control or repeat, and measurement accuracy cannot always be precisely determined. 16 Furthermore, animal lesions do not adequately simulate the complex 3D anatomy and, in particular, the thrombus frequently observed in large human AAAs.…”