Presentation
Hypotension. Growth of a treated abdominal aortic aneurysm with endovascular repair.
Patient Data
Excluded abdominal aortic aneurysm with biiliac stent. There is doppler within the aneurysmal sac, indicating a leakage coming from the left iliac stent. This is confirmed with CEUS, in which we see a jet arising from a defect in the endograft at this level.
Case Discussion
Endoleaks are the most common complications after endovascular aneurysm repair. It is defined as persistent blood flow within the excluded aneurysmal sac.
There are different types of endoleaks, depending on the origin of the blood reentry.
This is an example of a type III endoleak, in which there is a mechanical failure of the graft. The leak can come from a junctional separation of the modular components (IIIa) or a tear in the wall of the endograft (IIIb).
This is the most dangerous type of endoleak and requires prompt repair, as they don't spontaneously disapear. As the diagnosis was clear with US, no other image study was needed and the patient underwent inmediate vascular surgery.
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