title: Treatment of leaks after endovascular repair of aortic aneurysms.
abstract: OBJECTIVE
  To evaluate leaks after the endovascular repair of aortic aneurysms and treat them with occlusive therapy.
  
  
  METHODS
  Seventy patients (11 women, 59 men), aged 26-82 years (mean, 69.2 years), underwent transfemoral insertion of endoluminal stent-grafts for treatment of aortic aneurysms. Indications were traumatic pseudoaneurysms (n = 5) or arteriosclerotic aneurysms (n = 65). Aneurysms were thoracic (n = 5) or infrarenal (n = 65). To exclude the possibility of leaks, spiral computed tomography (CT) was performed at 3-month intervals. Patients with leaks that persisted unchanged longer than 3 months were referred for angiography and occlusive therapy.
  
  
  RESULTS
  At CT, 21 leaks were identified in 17 of 70 patients (24%). Only 11 of those 17 patients (65%) had leaks identified with conventional aortography. Selective angiography, however, depicted all of these. Eighteen of 21 leaks proved amenable to occlusive treatment: surgery (n = 1), further stent implantation (n = 4), or embolization (n = 13). In one leak, spontaneous occlusion occurred after 3 months. Two leaks in either the iliolumbar or the median sacral artery were inaccessible; one remained untreated, and the other was unsuccessfully treated. Mean follow-up of occlusive therapy was 6.8 months (range, 2-14 months).
  
  
  CONCLUSIONS
  Successful occlusion of perigraft leaks is feasible in most cases and can be performed without major complications.
authors.affiliation: Department of Radiology, University of Ulm, Steinhoevelstrasse 9, 89075 Ulm, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Görich
authors.forename: N
authors.initials: N
authors.lastname: Rilinger
authors.forename: R
authors.initials: R
authors.lastname: Sokiranski
authors.forename: S C
authors.initials: SC
authors.lastname: Krämer
authors.forename: C
authors.initials: C
authors.lastname: Ermis
authors.forename: A
authors.initials: A
authors.lastname: Schütz
authors.forename: H J
authors.initials: HJ
authors.lastname: Brambs
authors.forename: J
authors.initials: J
authors.lastname: Söldner
authors.forename: W
authors.initials: W
authors.lastname: Kaiser
authors.forename: L
authors.initials: L
authors.lastname: Sunder-Plassmann
authors.forename: R
authors.initials: R
authors.lastname: Pamler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D017541:Aneurysm, False / Q000601:surgery; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000601:surgery; D001027:Aortography; D001158:Arteries / Q000473:pathology; D001161:Arteriosclerosis / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002406:Catheterization, Peripheral; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000098:blood supply; D008159:Lumbar Vertebrae / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation; D012447:Sacrum / Q000098:blood supply; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome