While an aneurysm repair procedure can effectively treat bulged and swelling blood vessels, patients may still be at risk of endoleaks. This complication causes an aneurysm to grow larger and even rupture. Learn more about the basics of endoleaks, including endoleak definition, symptoms, and treatments.
What is An Endoleak?
An endoleak is a common complication of an endovascular aneurysm repair (EVAR). EVAR is a minimally-invasive procedure involving the placement of a fabric-covered metal mesh tube (endograft) within parts of the swelling aorta for patients with an aneurysm (AAA).
Functionally, EVAR treatments shape a new path for blood flow, diminishing the pressure on the swelling aorta. However, incomplete sealing might cause blood to enter the aneurysm cavity. This blood flow, known as an endoleak, can potentially lead to the risk of rupture if left untreated.
Types of Endoleaks
Endoleaks are classified into five different types. Among these, type II endoleak is the most common type, with up to 25% of patients having this type of endoleak after EVAR. Five types of endoleaks are as follows:
- Type I: when a leak occurs around the attachment in the bottom or top of the stent-graft.
- Type II: when the aneurysm sac is continually filled with blood from branch arteries.
- Type III: when blood leaks through a defect, tears, or misalignment of the stent-graft.
- Type IV: when blood leaks through the metal mesh tube.
- Type V: the source of the leak is unknown.
What are The Symptoms of Endoleaks?
Generally, endoleaks are asymptomatic. However, the overflowed blood might cause the aneurysm cavity to stretch and possibly burst without diagnosis or prompt medical interventions, which can be life-threatening.
The doctors will use several imaging tests, such as computed tomography (CT) scans, ultrasounds, or magnetic resonance imaging (MRI), to determine whether or not a patient is having an endoleak after EVAR. Following diagnosis, your doctor will determine the type of endoleak and provide an appropriate treatment plan that meets your specific needs.
Overall, surveilling the premature signs of endoleaks to prevent ruptures is likely to be a regular, lifelong practice for patients who have undergone EVAR surgery, as some leaks can occur years after a stent-graft placement. As a result, it’s crucial to follow up with post-surgery care and monitoring as a part of aneurysm care to avoid endoleaks.
How to Treat Endoleaks
Treating endoleaks are dependent on the characteristics of each endoleak and the size of the aneurysm sac. For the most part, the patient’s tolerance is typically one of many deciding factors in determining the treatment method.
For example, type II infrequently results in rupture as it often resolves without treatment due to the constant in-and-out blood passage. However, doctors might recommend closing the leak if the blood keeps flowing into the sac without a way out, causing it to keep growing to the point of bursting. Treatments to seal the leak may include using a glue-like substance to stop the bleeding and knotting the blood vessels with laparoscopic techniques.
In contrast to type I, type II requires immediate medical attention to prevent further sac expansion. Placing a cuff at both sides of the metal mesh tube, using a glue-like material to seal the leak, or placing another stent beyond the leaking end of the graft could be used to treat type II endoleak.
If you have questions about endoleaks or any conditions discussed here, we can help.
Vascular & Interventional Specialists offers screening, diagnosis, and treatment for a wide range of vascular conditions. We specialize in vascular surgery and interventional radiology – world class procedures right here in your world.
If you’re having trouble with any of these symptoms, you can reach us at (605) 540-1561. We’re here to help.