Presentation
Day 1 post EVAR.
Patient Data
Age: 80
Gender: Female
From the case:
Endoleak: type Ia
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Endovascular repair of abdominal AAA.
The superior extent of the graft extends to the origin the renal arteries. The renal arteries demonstrate ostial calcified atherosclerosis but are patent. No renal infarcts.
The graft extends into the common iliac vessels bilaterally.
There is a endoleak seen adjacent to the superior extent. The endoleak is present in the arterial phase imaging and washes out in the portal venous phase.
The native aortic sac measures 5.1cm in diameter (unchanged), filled with thrombus and locules of gas.
Conclusion:
The appearances are consistent with a type 1 endoleak (between the graft and the native aortic sac).
Case Discussion
Key learning points:
- endoleaks are the persistent flow of blood within the aneurysmal sac post EVAR
- endoleaks are common, occurring in 30-40% of patients
- type 1 endoleaks occur where the graft and aneurysm meet and are the result of an inadequate seal
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