Abstract
The inability to obtain or maintain a secure seal between a vessel
wall and a transluminally implanted intra-aneurysmal graft is a complication
unique to the evolving technique of endovascular aneurysm exclusion.
Because the term "leak" has long been associated with aneurysm rupture,
the term "endoleak" is proposed as a more definitive description
of this phenomenon. Embracing both persistent blood flow into the
aneurysmal sac from within or around the graft (graft related) and
from patent collateral arteries (nongraft related), endoleak can
be classified as primary or secondary depending on the time of occurrence
(within 30 days of implantation or following apparent initial seal,
respectively). Diagnostic techniques to detect endoleak include arteriography,
intraprocedural pressure monitoring, contrast-enhanced computed tomography,
abdominal X ray, and duplex scanning. Management strategies for endoleak
range from observation with periodic imaging surveillance to correction
by additional endoluminal or surgical procedures. Standardization
of the terminology describing this important sequela to endovascular
aneurysm exclusion should facilitate uniform reporting of clinical
trial data vital to the evaluation of this emerging technique.
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