Treatment of Endoleaks

An endoleak is a persistent leak of blood that occurs at the site of the stent or graft used in aneurysm repair. An aortic endoleak repair is a surgical procedure performed to correct a type of complication that can occur after endovascular aneurysm repair (EVAR) surgery or thoracic endovascular aortic aneurysm repair (TEVAR).

Types of Aortic Endoleaks

There are five main types of Aortic Endoleaks.

Type 1: Occurs when blood leaks out of the front or back portion of the stent graft and re-enters the aorta.
Type 2: Occurs when the blood leaks through a defect in the stent graft material itself.
Type 3: Occurs when blood leaks out of the endograft through a side branch vessel and re-enters the aorta at the back portion of the endograft.
Type 4: Occurs when blood continues to flow through the aorta, which was not completely occluded by the endograft.
Type 5: Occurs when blood leaks into the sac surrounding the endograft, creating a false aneurysm.

Endoleaks Treatment

In general, endoleak treatment involves three main options.


With observation, you will be monitored closely over time with regular imaging studies (such as CT scans) to assess the size and progression of the endoleak.

Observation may be appropriate for patients with small, stable endoleaks that are not causing significant symptoms or changes in the size of the endoleak over time. However, it is important to keep in mind that some endoleaks can increase in size over time, leading to potential complications such as aneurysm growth, rupture, or other serious problems. Therefore, close monitoring and follow-up is essential in cases of observation to ensure the patient's safety.

Endovascular Treatment and/or Open Surgery

Endovascular Treatment is a minimally invasive approach used to treat aortic endoleaks. Doctors deliver a stent or other device to the site of the leak through a catheter, which helps to seal the leak and prevent further blood flow from escaping. The endovascular approach has several advantages over traditional surgical methods, including a lower risk of complications, quicker recovery times, and less pain and scarring.

There are several different types of endovascular devices that can be used to treat aortic endoleaks, including:

Stent grafts: These are metal mesh tubes that can be placed inside the damaged section of the aorta to help seal the leak.

Coils: These are small metal devices that can be placed inside the leak to block the flow of blood.

Balloon-expandable devices: These are balloons that can be inflated at the site of the leak to help close it.

Embolization particles: Small particles can be injected into the blood vessels leading to the leak to block blood flow.

The endovascular treatment approach is typically performed under general anesthesia and using imaging guidance, such as X-ray or CT scan. The specific treatment options used will depend on the type, size, and location of the endoleak, as well as your overall health and medical history.

Surgery: For endoleaks that cannot be resolved with minimally invasive treatment, we offer open surgical repair aortic endoleaks. The procedure is performed under general anesthesia and involves making an incision in the patient's chest or abdomen to access the affected area of the aorta.

Our surgeons then repair or replace the damaged portion of the aorta, usually by using a synthetic patch or graft, to seal the leak. Open repair is typically reserved for patients with larger or more complex endoleaks, or for those who are not suitable for endovascular treatment. This approach may also be used for patients with endoleaks that have not resolved after previous endovascular treatments.

The specific surgical approach will depend on the type of endoleak, the location, and your individual anatomy. The goal of the procedure is to prevent further blood flow into the aneurysm, which can reduce the risk of aneurysm rupture.

Make an Appointment

To schedule an evaluation with a Frankel Cardiovascular Center physician, call 888-287-1082. Or visit the Make a Cardiovascular Appointment page to learn what to expect when you call us.

Physicians: To refer a patient, call M-Line at 800-962-3555.