Download PDF
Semin intervent Radiol 2020; 37(04): 371-376
DOI: 10.1055/s-0040-1715874
Review Article

Review of Type III Endoleaks

Jordan B. Stoecker
1   Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
,
Julia D. Glaser
2   Division of Vascular Surgery and Endovascular Therapy, University of Pennsylvania Health System, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

Endoleak remains a significant challenge to endovascular aneurysm repair, particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy with increasing number of device components. Intervention is recommended for both type I and III endoleaks due to their risk of rupture, and endovascular techniques are the favored modality with placement of a bridging endograft over the endoleak defect. Conversion to open surgical repair remains the definitive option in cases where less invasive methods have failed or are precluded. In this article, the authors review evidence on the etiology, incidence, diagnosis, and current techniques for type III endoleak management.

Keywords

endoleak - aortic aneurysm - surgery - stent graft - interventional radiology - endovascular aneurysm repair


Publication History

Article published online:
01 October 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers
333 Seventh Avenue, New York, NY 10001, USA.

 

  • References

  • 1 Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5 (06) 491-499
    CrossrefPubMedGoogle Scholar
  • 2 Dua A, Kuy S, Lee CJ, Upchurch Jr GR, Desai SS. Epidemiology of aortic aneurysm repair in the United States from 2000 to 2010. J Vasc Surg 2014; 59 (06) 1512-1517
    CrossrefPubMedGoogle Scholar
  • 3 Blankensteijn JD, de Jong SE, Prinssen M. , et al. Dutch Randomized Endovascular Aneurysm Management (DREAM) Trial Group. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med 2005; 352 (23) 2398-2405
    CrossrefPubMedGoogle Scholar
  • 4 Patel R, Sweeting MJ, Powell JT, Greenhalgh RM. EVAR Trial Investigators. Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet 2016; 388 (10058): 2366-2374
    CrossrefPubMedGoogle Scholar
  • 5 Schermerhorn ML, Buck DB, O'Malley AJ. , et al. Long-term outcomes of abdominal aortic aneurysm in the Medicare population. N Engl J Med 2015; 373 (04) 328-338
    CrossrefPubMedGoogle Scholar
  • 6 Chaikof EL, Blankensteijn JD, Harris PL. , et al. Ad Hoc Committee for Standardized Reporting Practices in Vascular Surgery of The Society for Vascular Surgery/American Association for Vascular Surgery. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 2002; 35 (05) 1048-1060
    CrossrefPubMedGoogle Scholar
  • 7 Görich J, Rilinger N, Sokiranski R. , et al. Treatment of leaks after endovascular repair of aortic aneurysms. Radiology 2000; 215 (02) 414-420
    CrossrefPubMedGoogle Scholar
  • 8 Bucci F, Fiengo L, Valerio N, Ferdani M. Late type IIIb endoleak after endovascular aneurysm repair: case report and review of the literature. G Chir 2011; 32 (6-7): 329-333
    PubMedGoogle Scholar
  • 9 Cronenwett J. Rutherford’s Vascular Surgery, 7th Edition. Cronenwett and Johnson, Eds. Philadelphia, PA: Saunders Elsevier; 2010
    Google Scholar
  • 10 Ueda T, Takaoka H, Petrovitch I, Rubin GD. Detection of broken sutures and metal-ring fractures in AneuRx stent-grafts by using three-dimensional CT angiography after endovascular abdominal aortic aneurysm repair: association with late endoleak development and device migration. Radiology 2014; 272 (01) 275-283
    CrossrefPubMedGoogle Scholar
  • 11 Leszczyński J, Macioch W, Chudziński W, Gałązka Z. Late type III endoleak after thoracic endovascular aneurysm repair and previous infrarenal stent graft implantation - a case report and review of the literature. Wideochir Inne Tech Malo Inwazyjne 2017; 12 (03) 320-324
    PubMedGoogle Scholar
  • 12 Maleux G, Poorteman L, Laenen A. , et al. Incidence, etiology, and management of type III endoleak after endovascular aortic repair. J Vasc Surg 2017; 66 (04) 1056-1064
    CrossrefPubMedGoogle Scholar
  • 13 Parmer SS, Carpenter JP, Stavropoulos SW. , et al. Endoleaks after endovascular repair of thoracic aortic aneurysms. J Vasc Surg 2006; 44 (03) 447-452
    CrossrefPubMedGoogle Scholar
  • 14 Lal BK, Zhou W, Li Z. , et al. OVER Veterans Affairs Cooperative Study Group. Predictors and outcomes of endoleaks in the Veterans Affairs Open Versus Endovascular Repair (OVER) Trial of Abdominal Aortic Aneurysms. J Vasc Surg 2015; 62 (06) 1394-1404
    CrossrefPubMedGoogle Scholar
  • 15 Tadros RO, Faries PL, Ellozy SH. , et al. The impact of stent graft evolution on the results of endovascular abdominal aortic aneurysm repair. J Vasc Surg 2014; 59 (06) 1518-1527
    CrossrefPubMedGoogle Scholar
  • 16 Theodoridis PG, Staramos DN, Ptochis N. , et al. Combined Type III and Type II endoleaks after endovascular aneurysm repair: presentation of 2 cases and a literature review. Ann Vasc Surg 2019; 55: 308.e5-308.e10
    CrossrefPubMedGoogle Scholar
  • 17 Swerdlow NJ, McCallum JC, Liang P. , et al. Select type I and type III endoleaks at the completion of fenestrated endovascular aneurysm repair resolve spontaneously. J Vasc Surg 2019; 70 (02) 381-390
    CrossrefPubMedGoogle Scholar
  • 18 Gleason TG. Endoleaks after endovascular aortic stent-grafting: impact, diagnosis, and management. Semin Thorac Cardiovasc Surg 2009; 21 (04) 363-372
    CrossrefPubMedGoogle Scholar
  • 19 Appoo JJ, Moser WG, Fairman RM. , et al. Thoracic aortic stent grafting: improving results with newer generation investigational devices. J Thorac Cardiovasc Surg 2006; 131 (05) 1087-1094
    CrossrefPubMedGoogle Scholar
  • 20 Scali ST, Goodney PP, Walsh DB. , et al. National trends and regional variation of open and endovascular repair of thoracic and thoracoabdominal aneurysms in contemporary practice. J Vasc Surg 2011; 53 (06) 1499-1505
    CrossrefPubMedGoogle Scholar
  • 21 Matsumura JS, Cambria RP, Dake MD, Moore RD, Svensson LG, Snyder S. TX2 Clinical Trial Investigators. International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results. J Vasc Surg 2008; 47 (02) 247-257 , discussion 257
    CrossrefPubMedGoogle Scholar
  • 22 Ellozy SH, Carroccio A, Minor M. , et al. Challenges of endovascular tube graft repair of thoracic aortic aneurysm: midterm follow-up and lessons learned. J Vasc Surg 2003; 38 (04) 676-683
    CrossrefPubMedGoogle Scholar
  • 23 Armerding MD, Rubin GD, Beaulieu CF. , et al. Aortic aneurysmal disease: assessment of stent-graft treatment-CT versus conventional angiography. Radiology 2000; 215 (01) 138-146
    CrossrefPubMedGoogle Scholar
  • 24 Görich J, Rilinger N, Sokiranski R. , et al. Leakages after endovascular repair of aortic aneurysms: classification based on findings at CT, angiography, and radiography. Radiology 1999; 213 (03) 767-772
    CrossrefPubMedGoogle Scholar
  • 25 Baum RA, Carpenter JP, Tuite CM. , et al. Diagnosis and treatment of inferior mesenteric arterial endoleaks after endovascular repair of abdominal aortic aneurysms. Radiology 2000; 215 (02) 409-413
    CrossrefPubMedGoogle Scholar
  • 26 Cohen EI, Weinreb DB, Siegelbaum RH. , et al. Time-resolved MR angiography for the classification of endoleaks after endovascular aneurysm repair. J Magn Reson Imaging 2008; 27 (03) 500-503
    CrossrefPubMedGoogle Scholar
  • 27 Pitton MB, Schweitzer H, Herber S. , et al. MRI versus helical CT for endoleak detection after endovascular aneurysm repair. AJR Am J Roentgenol 2005; 185 (05) 1275-1281
    CrossrefPubMedGoogle Scholar
  • 28 Faries PL, Agarwal G, Lookstein R. , et al. Use of cine magnetic resonance angiography in quantifying aneurysm pulsatility associated with endoleak. J Vasc Surg 2003; 38 (04) 652-656
    CrossrefPubMedGoogle Scholar
  • 29 Hasebroock KM, Serkova NJ. Toxicity of MRI and CT contrast agents. Expert Opin Drug Metab Toxicol 2009; 5 (04) 403-416
    CrossrefPubMedGoogle Scholar
  • 30 Kapetanios D, Kontopodis N, Mavridis D, McWilliams RG, Giannoukas AD, Antoniou GA. Meta-analysis of the accuracy of contrast-enhanced ultrasound for the detection of endoleak after endovascular aneurysm repair. J Vasc Surg 2019; 69 (01) 280-294.e6
    CrossrefPubMedGoogle Scholar
  • 31 Matsumura JS, Ryu RK, Ouriel K. Identification and implications of transgraft microleaks after endovascular repair of aortic aneurysms. J Vasc Surg 2001; 34 (02) 190-197 , discussion 369–370
    CrossrefPubMedGoogle Scholar
  • 32 Rubin BG, Marine L, Parodi JC. An algorithm for diagnosis and treatment of type II endoleaks and endotension after endovascular aneurysm repair. Perspect Vasc Surg Endovasc Ther 2005; 17 (02) 167-172
    CrossrefPubMedGoogle Scholar
  • 33 Fillinger MF, Greenberg RK, McKinsey JF, Chaikof EL. Society for Vascular Surgery Ad Hoc Committee on TEVAR Reporting Standards. Reporting standards for thoracic endovascular aortic repair (TEVAR). J Vasc Surg 2010; 52 (04) 1022-1033 , 1033.e15
    CrossrefPubMedGoogle Scholar
  • 34 Conrad MF, Adams AB, Guest JM. , et al. Secondary intervention after endovascular abdominal aortic aneurysm repair. Ann Surg 2009; 250 (03) 383-389
    CrossrefPubMedGoogle Scholar
  • 35 Lange C, Aasland JK, Ødegård A, Myhre HO. The durability of EVAR–what are the evidence and implications on follow-up?. Scand J Surg 2008; 97 (02) 205-212
    CrossrefPubMedGoogle Scholar
  • 36 Fairman RM, Criado F, Farber M. , et al. VALOR Investigators. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial. J Vasc Surg 2008; 48 (03) 546-554
    CrossrefPubMedGoogle Scholar
  • 37 Harris PL, Vallabhaneni SR, Desgranges P, Becquemin JP, van Marrewijk C, Laheij RJ. Incidence and risk factors of late rupture, conversion, and death after endovascular repair of infrarenal aortic aneurysms: the EUROSTAR experience. European Collaborators on Stent/graft techniques for aortic aneurysm repair. J Vasc Surg 2000; 32 (04) 739-749
    CrossrefPubMedGoogle Scholar
  • 38 Eng ML, Brewer MB, Rowe VL, Weaver FA. Treatment options for late type III endoleaks after endovascular aneurysm repair. Ann Vasc Surg 2015; 29 (03) 594.e5-594.e9
    CrossrefPubMedGoogle Scholar
  • 39 White SB, Stavropoulos SW. Management of endoleaks following endovascular aneurysm repair. Semin Intervent Radiol 2009; 26 (01) 33-38
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Cao P, De Rango P, Verzini F, Parlani G. Endoleak after endovascular aortic repair: classification, diagnosis and management following endovascular thoracic and abdominal aortic repair. J Cardiovasc Surg (Torino) 2010; 51 (01) 53-69
    PubMedGoogle Scholar
  • 41 Teutelink A, van der Laan MJ, Milner R, Blankensteijn JD. Fabric tears as a new cause of type III endoleak with Ancure endograft. J Vasc Surg 2003; 38 (04) 843-846
    CrossrefPubMedGoogle Scholar
  • 42 Schuurman JP, Fioole B, van den Heuvel DA, de Vries JP. Endovascular therapy for recurrent type III endoleak. Vasc Endovascular Surg 2010; 44 (02) 123-125
    CrossrefPubMedGoogle Scholar
  • 43 Jim J, Rubin BG, Sanchez LA. Use of a bifurcated endovascular graft for treatment of endograft migration with major endoleak. Vascular 2012; 20 (01) 49-53
    CrossrefPubMedGoogle Scholar
  • 44 van Lammeren GW, Fioole B, Waasdorp EJ, Moll FL, van Herwaarden JA, de Vries JP. Long-term follow-up of secondary interventions after endovascular aneurysm repair with the AneuRx endoprosthesis: a single-center experience. J Endovasc Ther 2010; 17 (03) 408-415
    CrossrefPubMedGoogle Scholar
  • 45 Garg T, Baker LC, Mell MW. Postoperative surveillance and long-term outcomes after endovascular aneurysm repair among Medicare beneficiaries. JAMA Surg 2015; 150 (10) 957-963
    CrossrefPubMedGoogle Scholar