title: Endoleak visualized with carbon dioxide angiography during endovascular aneurysm repair using the Endurant stent-graft.
abstract: OBJECTIVE
  To make interventionists aware of the potential for type IV endoleak on completion carbon dioxide (CO2) angiography during endovascular aneurysm repair (EVAR) using the Endurant stent-graft.
  
  
  METHODS
  A 74-year-old man with chronic kidney disease underwent EVAR with an Endurant stent-graft using CO2 angiography to guide graft placement. Completion CO2 angiography demonstrated immediate accumulation of CO2 in the aneurysm sac suggestive of an endoleak, but confirmatory angiography with conventional iodinated contrast showed no evidence of an endoleak. We speculate that this is a type IV endoleak, and graft porosity may be responsible.
  
  
  CONCLUSIONS
  Interventionists should be alerted to the possibility of visualizing these endoleaks through Endurant stent-grafts under CO2 angiography. Further work should be done to elucidate the exact mechanism of the endoleak.
authors: Geisinger Medical Center, Danville, Pennsylvania, USA.
authors: Robert P
authors: RP
authors: Garvin
authors: Evan J
authors: EJ
authors: Ryer
authors: J Brian
authors: JB
authors: Kendrick
authors: David P
authors: DP
authors: Franklin
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D002245:Carbon Dioxide; D003287:Contrast Media; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008297:Male; D016062:Porosity; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex
chemical_list: D003287:Contrast Media; D002245:Carbon Dioxide