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Imaging Techniques for Detection and Management of Endoleaks after Endovascular Aortic Aneurysm Repair¹

¹ From the Department of Radiology, Division of Interventional Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104. Received October 7, 2005; revision requested November 14; revision received December 19; accepted January 16, 2006; final version accepted May 1; final review and update by S.W.S. January 11, 2007. Address correspondence to S.W.S. (e-mail: stav{at}uphs.upenn.edu).

Endovascular aortic aneurysm repair (EVAR) is evolving into a viable alternative to open surgical repair for many patients with abdominal and thoracic aortic aneurysms. Endoleak development is a complication of EVAR and represents one of the limitations of this procedure. Endoleaks represent blood flow outside the stent-graft lumen but within the aneurysm sac. Lifelong imaging surveillance of patients after EVAR is critical to detect endoleaks for the patient's benefit and to determine the long-term performance of the stent-graft. Although computed tomographic angiography is the most commonly used examination for imaging surveillance, magnetic resonance angiography, ultrasonography, and digital subtraction angiography all have a role in endoleak detection and management. This review will focus on imaging techniques used for endoleak detection and the role imaging surveillance plays in the overall care of the post-EVAR patient.

© RSNA, 2007

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