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Rofo 2005; 177(1): 24-34
DOI: 10.1055/s-2004-813808
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© Georg Thieme Verlag KG Stuttgart · New York

Klassifikation und Therapie von Endolecks nach endovaskulärer Behandlung von abdominellen Aortenaneurysmen

Classification and Treatment of Endoleaks after Endovascular Treatment of Abdominal Aortic AneurysmsM. B. Pitton1 , W. Schmiedt2 , A. Neufang2 , C. Düber3 , M. Thelen1
  • 1Klinik für Radiologie (Direktor: Prof. Dr. M. Thelen), Klinikum der Johannes Gutenberg-Universität Mainz
  • 2Klinik für Herz-, Thorax- und Gefäßchirurgie (Direktor: Prof. Dr. C. Vahl), Klinikum der Johannes Gutenberg-Universität Mainz
  • 3Institut für Klinische Radiologie, Klinikum Mannheim gGmbH, Universitätsklinikum Mannheim (Direktor: Prof. Dr. C. Düber)
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Publication History

Publication Date:
19 January 2005 (online)

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Zusammenfassung

Die vorliegende Arbeit beschreibt die derzeit gültige Klassifikation von Endolecks nach endovaskulärer Therapie von abdominellen Aortenaneurysmen. Sie gibt damit einen Überblick über die wesentlichen Probleme dieses endovaskulären Therapieverfahrens. Die korrekte Endoleckklassifizierung ist die wesentliche Voraussetzung für eine interdisziplinäre Befunddiskussion. Sie ist für die fachgerechte Therapieentscheidung unentbehrlich und sollte bei der Befundbeschreibung berücksichtigt werden. Unabhängig vom Prothesentyp und von Materialeigenschaften werden in der Literatur derzeit fünf Endolecktypen definiert: Verankerungsleckagen (Typ I), Leckagen durch Kollateralarterien (Typ II), Leckagen durch Defekte der Stentprothese (Typ III), Leckagen durch Materialporosität (Typ IV) und Endotension (Typ V). Die Endoleckursachen werden zusammenfassend dargestellt und Behandlungsmöglichkeiten aufgezeigt.

Abstract

This article describes the classification of endoleaks after endovascular treatment of abdominal aortic aneurysms, thereby summarizing the most important problems of this endovascular technique. The correct classification of endoleaks is a prerequisite for interdisciplinary discussion. It is indispensable for professional reporting of the pathological findings and for the decision making as to the adequate treatment of endoleaks. Irrespective of the types of stent graft and property of the material, five endoleak types are defined in the literature: leakage at the anchor sites (type I); leakage due to collateral arteries (type II); defective stent grafts (type III); leakage due to porosity of the graft material (type IV); and endotension (type V). The causes of endoleaks are discussed and treatment options are reviewed for the diverse pathologic findings.

Key words

Abdominal aortic aneurysm - endovascular treatment - endoleaks

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PD Dr. Michael B. Pitton

Klinik für Radiologie, Universitätskliniken

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55101 Mainz

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Fax: ++ 49/61 31/17 66 33

Email: pitton@radiologie.klinik.uni-mainz.de