Intrasac flow velocities predict sealing of type II endoleaks after endovascular abdominal aortic aneurysm repair

DUS shows extrastent flow after infrarenal AAA repair with stent graft. Endoleak is result of patent preoperative IMA.

DUS and spectral velocities of type II endoleak after infrarenal AAA repair with endovascular graft. To and fro flow is seen within aneurysm during systole and diastole, respectively. For this study, spectral flow velocities were obtained adjacent to aneurysm wall (above-right image). This patient had persistent endoleak with postoperative velocities between 190 and 200 cm/s. It is important to notice position of where velocities were measured because velocities will decrease if flow is measured further away from wall (bottom-right image).

DUS of type II endoleak from IMA. Spectral flow velocities within aneurysm sac near wall are 19 cm/s. This endoleak resolved spontaneously and has not recurred on follow-up imaging.

Comparison of postoperative intrasac flow velocities to intrasac flow velocities at last follow-up in patients with persistent type II endoleaks. Mean follow-up period is 29.9 months. Over time, there is little change in intrasac systolic velocities even in those who underwent transarterial coil embolization. One patient with laparascopic clipping of IMA and lumbar artery had complete resolution of endoleak (patient 5).