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Endoleaks Following Endovascular Aortic Aneurysm Repair: Clinical Significance and Treatment Modalities

Division of Vascular Surgery University of Pittsburgh School of Medicine, Pittsburgh, PA

Albert Zajko, M.D.

Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA

The Achilles heel of endovascular management of abdominal aortic aneurysms (AAA) remains the frequent development of endoleaks. We reviewed our experience over 4 years with two devices used to treat 158 patients with AAA. Forty-one endoleaks were noted for a total incidence of 27%. Two-thirds resolved spontaneously over a 6-month observation period. Proximal endoleaks were associated with neck angulation and most resolved on their own. Distal endoleaks were persistent and required coiling to obliterate the flow around the graft. Other endoleaks were self-limited in general. The incidence of endoleaks decreased significantly with experience and recent cases show no significant differences among the two devices. Long-term follow-up of treated or spontaneously sealed endoleaks reveals shrinkage of the AAA sac similar to patients with no endoleaks. We conclude that the incidence of endoleaks can be reduced with experience and an aggressive management policy can limit their potential danger.

Key Words: Abdominal aortic aneurysm • endovascular repair • complications • endoleaks • treatment

Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 13, No. 1, 1-14 (2000)
DOI: 10.1177/153100350001300102


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