Clinical significance of type I endoleak on completion angiography.
OBJECTIVE
Type I endoleak is known to be associated with sac enlargement and occasional rupture, therefore, the treatment of type I endoleak is recommended at the time of diagnosis. The aim of this study was to identify the significance of early type I endoleak found on completion angiography.


METHODS
Between January 2000 and December 2012, a total of 86 patients underwent endovascular abdominal aortic aneurysm repair (EVAR) and 10 patients (11.6%) were diagnosed with type Ia endoleak on completion angiography. Clinical and radiologic data were reviewed retrospectively.


RESULTS
Of the 10 patients, two underwent EVAR with custom-made stent-grafts in the initial stage and both of them needed immediate treatment: one case involved open repair while the other involved insertion of an additional stent-graft. In 8 patients, the amount of leakage decreased after repeated balloon molding. They were managed conservatively and followed up with computed tomography angiography within 2 weeks after EVAR. In 7 of the 8 cases, type Ia endoleaks disappeared. In one patient with a persistent endoleak and a folded posterior wall of the stent-graft, coil embolization was performed 1 week after EVAR. With a median follow-up of 12 months (range, 1-61 months), no patients showed recurrence of type I endoleak or sac expansion.


CONCLUSIONS
Type I endoleaks diagnosed on completion angiography sealed spontaneously in 7 of 10 patients (70.0%). In cases of decreased amounts of leakage after balloon molding, simple observation may be an alternative to repetitive procedures. The long-term follow-up of patients with self-sealed type I endoleaks is mandatory.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Suh Min
SM
Kim
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Hwan Do
HD
Ra
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Sang-Il
SI
Min
Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Hwan Jun
HJ
Jae
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Jongwon
J
Ha
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Seung-Kee
SK
Min
Abdominal aortic aneurysm; Endoleak; Endovascular aneurysm repair