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Pulmonary Artery Aneurysm
Joseph Junewick, MD FACR
over 4 years ago
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Type II Aortic Endoleak

Case Detail

Anatomy: Vascular-Lymphatic
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 2 years ago
Updated: about 1 year ago
Tags: ADULT
Modality/Study Types: CT
Activities:
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History

Evaluate abdominal aortic stent.


Case Images


Diagnosis

Type II Aortic Endoleak

Findings

CT – Focal peripheral enhancement of the anterior aspect of the excluded aneurysm sac.

Discussion

Endoleak, defined as the leakage of blood into an excluded aneurysm sac after endovascular stent graft placement, is a common complication and may lead to aneurysm progression and rupture. Type I endoleak is related to leaking at the graft ends due to inadequate seal. Type II endoleak is most common and occurs when there is retrograde flow into the aneurysm sac by an excluded aortic branch (usually a lumbar branch or inferior mesenteric artery). Flow through the excluded branch may be too slow to detect by ultrasound. While this is usually a self-limited problem, follow up imaging is necessary to monitor the diameter of the aneurysm. Type III is a leak through defective stent material. Type IV is secondary porous graft material. In Type V (“endotension”) endoleak, there is aneurysm progression without definable cause.

Reference

Bashir MR, Ferral H, Jacobs C, McCarthy W, et al. Endoleaks after endovascular abdominal aortic aneurysm repair: Management strategies according to CT findings. AJR (2009); 192:W178-W186.

Contributor

Frederick J. Kellaway, MD



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