Endovascular Treatment of Type II Endoleaks: Update and Overview

Endoleaks are a common complication following endovascular aneurysm repair, despite EVAR being the preferred method for the repair of abdominal aortic aneurysms. Endoleaks are continued blood flow into the aneurysmal sac, or more broadly elevated pressure outside of the endograft, and are classified into five types based on the source of blood flow or elevated pressure. Type II endoleaks are the most common and are a result of retrograde flow to the sac most commonly from the inferior mesenteric artery or lumbar artery. Endovascular treatment options for type II endoleaks include transarterial, transcaval, translumbar, and transabdominal approaches. This review discusses the indication for endovascular treatment of type II endoleaks, the selection of approach, and technical considerations.