CT Angiography Evaluation of Endoleak after Thoracic Endovascular Aortic Repair in Thoracic Aortic Aneurysm
Ariya Tanasoontornrerk MD*, Jitladda Wasinrat MD*, Thanongchai Siriapisith MD*, Worawong Slisatkorn MD**
Affiliation : * Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ** Division of Cardiovascular Thoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Analyze the incidence and findings of endoleak after thoracic endovascular aortic repair by using CT angiography.
Material and method: Between August 2006 and December 2008, 68 patients diagnosed with thoracic aortic aneurysm
underwent thoracic endovascular aortic repair and were included in the present study. The patients were 47 men and 21
women, with a mean age of 69 + 9.4 years old. Thoraco-abdominal CT angiographic images (64-slice MDCT) after
operation of 68 patients were retrospectively reviewed to evaluate incidence of endoleak and classify findings of endoleak.
Results : Endoleaks were detected in 26 patients (38.2%). There were type I endoleaks in three cases (11.5%), type II
endoleaks in 22 cases (84.6%), and type III endoleaks in one case (3.9%). Type II endoleaks were detected as peritubular
collection, mostly located at periphery of the aneurysm. Eleven cases (50%) of type II endoleaks were supplied by left
subclavian artery. Twenty patients who had completed 1, 3, and 6 months follow-up CT angiography were selected for further
evaluation of changing in size of aneurysm. The measurement of the thoracic aneurysm showed no decreasing of the
maximum length of diameter and volume of the aneurysmal sac in endoleak group.
Conclusion : Follow-up CT angiography is useful for detection and characterization of endoleak after endovascular aortic
repair of thoracic aneurysm. Most of type II endoleaks show peritubular (collection) shape and locate at the periphery.
Patients with endoleak after thoracic endovascular aortic repair tend to continue to have sac expansion.
Keywords : CT angiography, Endovascular aortic repair, Aortic aneurysm, Multidetector row CT
