Klassifikation und Therapie von Endolecks nach endovaskulärer Behandlung von abdominellen Aortenaneurysmen

Abstract

This article describes the classification of endoleaks after endovascular treatment of abdominal aortic aneurysms, thereby summarizing the most important problems of this endovascular technique. The correct classification of endoleaks is a prerequisite for interdisciplinary discussion. It is indispensable for professional reporting of the pathological findings and for the decision making as to the adequate treatment of endoleaks. Irrespective of the types of stent graft and property of the material, five endoleak types are defined in the literature: leakage at the anchor sites (type I); leakage due to collateral arteries (type II); defective stent grafts (type III); leakage due to porosity of the graft material (type IV); and endotension (type V). The causes of endoleaks are discussed and treatment options are reviewed for the diverse pathologic findings.

Endovascular Repair for a Ruptured AAA due to a Combined Type IIIb and Ia Endoleak

“…Endoleak is a potential complication of EVAR which could jeopardize surgical success of EVAR [ 1 ]. It can happen because of leakage at sealing zones (types Ia, Ib, and Ic), leakage due to side branches arising from within the aneurismal sac (types IIa and IIb), leakage from graft defects (types IIIa and IIIb), and leakage due to graft porosity (type IV) [ 1 ]. Additionally, we can have aneurysm sac enlargement (endotension) without detectable endoleak (type V) [ 1 ].…”

“…It can happen because of leakage at sealing zones (types Ia, Ib, and Ic), leakage due to side branches arising from within the aneurismal sac (types IIa and IIb), leakage from graft defects (types IIIa and IIIb), and leakage due to graft porosity (type IV) [ 1 ]. Additionally, we can have aneurysm sac enlargement (endotension) without detectable endoleak (type V) [ 1 ]. Endoleaks are also categorized to early or late type, depending on the time of occurrence [ 1 ].…”

“…Additionally, we can have aneurysm sac enlargement (endotension) without detectable endoleak (type V) [ 1 ]. Endoleaks are also categorized to early or late type, depending on the time of occurrence [ 1 ]. Some types of endoleak are directly connected to serious complications, aneurysm 97 rupture, and even death [ 5 ].…”

“…Endoleak is considered the Achilles heel of endovascular aortic repair (EVAR). Endoleak classification has been described elsewhere in detail [ 1 ]. Type I (a and b) is associated with a poor sealing zone and can arise immediately after the initial implantation or during the late follow-up [ 2 ].…”

Dual-Energy CT zur postoperativen Langzeitkontrolle nach endovaskulär therapierten abdominellen Aortenaneurysmen

“…Bildkontraste in diesem Datensatz entsprechen weitgehend denjenigen eines regulären, bei 120 kV akquirierten Datensatzes [13]. [17]. Die diagnostische Sicherheit von Diagnose oder Ausschluss eines Endolecks erfolgte anhand einer 4-stufigen LikertSkala, (1 = sicherer Ausschluss eines Endolecks, 2 und 3 = Endoleck unwahrscheinlich bzw.…”