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Ask the Experts: Does Treating Type II Endoleaks and the Aneurysm Sac Make a Difference?
Nearly 30 years after the implantation of the first aortic endograft, the natural history and hemodynamic and clinical significance of type II endoleaks remain controversial. The coexistence and concomitant treatment of other types of endoleaks continue to prevent meaningful conclusions from being drawn regarding the significance of successful treatment of an isolated type II endoleak. Type II endoleaks may simply represent the nidus of a more intricate endoleak flow pattern—one that may involve subtle seal zone leaks not detected by current imaging techniques. Given that these endoleaks occur in thrombus-ridden aneurysm sacs with unpredictable flow channels, dynamic, high-resolution, real-time, four-dimensional imaging may be the only means of detecting these endoleaks that may pressurize the sac spontaneously and intermittently. Close surveillance of all type II endoleaks is warranted, with emphasis on evaluation for subtle type I and/or type III endoleaks.
Source: Endovascular Today