Endoleak type IIIb - after repair of saccular thoracic aortic aneurysm

Discussion:

CT angiography is routinely undertaken in patients with stent grafts to assess graft position, patency, and to look for complications such as an endoleak. In this case, contrast is seen leaking into the aneurysm neck consistent with an endoleak.

As the leak is away from the graft ends and no collateral vessels are seen filling the aneurysm, these findings suggest endograft fracture or a defect in its middle portion in keeping with a type 3b endoleak. Although not definitively demonstrated, there is an area suspicious for a defect with the aortic graft in the inferior anterior aspect.

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