Follow up CT angiography post EVAR: Endoleaks detection, classification and management planning

The goal of this study was to highlight the role of follow up CT angiography examination in detection and classification of endoleaks and therefore deciding management plans after endovascular abdominal aortic aneurysm repair (EVAR). During one year duration 37 patients who have been operated were examined 1 and 6 months after EVAR as routine follow up. The images obtained were interpreted and reconstructed using dedicated software and work stations. Out of 37 cases, 14 cases (37.8%) had positive endoleaks and 23 cases (62.2%) were free. Type I endoleak was diagnosed in 4 cases (10.8%) and type II endoleaks was diagnosed in 10 cases (27%) as 7 cases (18.9%) showed leak through lumbar arteries and 3 cases (8.1%) showed leak through the inferior mesenteric arteries. CT angiography can accurately detect and classify endoleaks and thus determine line of treatment. Endoleaks are often asymptomatic and may become evident intra operatively or many years after the operation, therefore lifelong imaging supervision is necessary.