The Achilles heel of endovascular management of abdominal aortic aneurysms (AAA) remains
the frequent development of endoleaks. We reviewed our experience over 4 years with
two devices used to treat 158 patients with AAA. Forty-one endoleaks were noted for
a total incidence of 27%. Two-thirds resolved spontaneously over a 6-month observation
period. Proximal endoleaks were associated with neck angulation and most resolved
on their own. Distal endoleaks were persistent and required coiling to obliterate
the flow around the graft. Other endoleaks were self-limited in general. The incidence
of endoleaks decreased significantly with experience and recent cases show no significant
differences among the two devices. Long-term follow-up of treated or spontaneously
sealed endoleaks reveals shrinkage of the AAA sac similar to patients with no endoleaks.
We conclude that the incidence of endoleaks can be reduced with experience and aggressive
management policy can limit their potential danger.
Abdominal aortic aneurysm - endovascular repair - complications - endoleaks - treatment
