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Angiography of Leaks After Endovascular Repair of Infrarenal Aortic Aneurysms

Johannes Görich1, Norbert Rilinger1, Stefan Krämer1, Roman Sokiranski1, Reinhard Pamler2, Cengiz Ermis1 and Xaver Kapfer2

1 Department of Radiology, University of Ulm, Steinhoevelstra. 9, 89075 Ulm, Germany
2 Department of Thoracic and Vascular Surgery, University of Ulm, 89075 Ulm, Germany.



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  		Fig. 1. —69-year-old man with Vanguard bifurcated graft (Boston Scientific, Hilden, Germany). Subselective angiogram shows endoleak is supplied by inferior mesenteric artery via superior mesenteric artery. Note arc of Riolan (open arrows) and outflow of leak (solid arrow) through right-sided lumbar artery.

 


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  		Fig. 2. —59-year-old man with Talent graft (Hosmed, Oberhaching-München, Germany). Superselective leakography via coaxial catheter (Rapid Transit; Cordis, Haan, Germany) reveals outflow of perigraft leak from lumbar artery (arrow).

 


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  		Fig. 3. —75-year-old patient with bifurcated graft (Corvita Europe, Brussels, Belgium). Superselective leakography of right-sided distal perigraft leak reveals multiple efferent arteries: right testicular artery (open arrows), left lumbar artery (solid straight arrow), inferior mesenteric artery (curved arrow), and median sacral artery (arrowheads).

 


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  		Fig. 4. —79-year-old man with dorsolateral endoleak from Talent bifurcated stent graft (Hosmed, Oberhaching-München, Germany). Leak (solid arrows) is supplied by collaterals from iliolumbar artery. No superselective access was possible because of small diameter of supplying vessels. Note outflow through right-sided lumbar artery (open arrow).

 

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