The cardiovascular system consisting of the heart and the blood vessels of 100 000 kilometres in length, plays an important role in the human body. Besides its function of providing oxygen and nutrients to all of the cells in the body through blood circulation, it also acts as removing the body waste and performing metabolism function for the body. The blood circulation itself is so long that it can take up to 100 000 kilometres in length alone. There could be many diseases that affect the cardiovascular system, either affecting the heart or the blood vessel or combination of both. People with symptoms related to cardiovascular issues will usually ask for treatment and medicine to feel better.
What is endoleak? Endoleak is the leaking of the blood outside of the stent graft and within an aneurysm sac. To understand what exactly is the endoleak, it would be better to understand a little bit more on what aneurysm is. Aneurysm are bulges that weaken the walls of the blood vessels. It is the enlargement of the blood vessels caused by the weakness in the arterial well. Aneurysm can happen to many locations in the body but the most common is the heart. Aortic aneurysm is an aneurysm that is associated with the heart. Aortic aneurysm affects the largest blood vessel known as the aorta. In most cases of aortic aneurysm, a person is less likely to have any symptoms until. In fact, aortic aneurysm is usually found accidentally when a person complains of stomach pain or discomfort. Pulsating feeling inside the abdomen can give signs of an aortic aneurysm. The best way to know if there is aortic aneurysm is to do regular health screening. Once a person is diagnosed with an aortic aneurysm, doctors will usually monitor the unruptured aortic aneurysm and provide treatments as preventative measures.
In cases of a large or rapidly growing aortic aneurysm, doctors are likely to do surgery such as endovascular aneurysm repair (EVAR) to place an endovascular graft by using a catheter. The endovascular graft is a stent-graft in the shape of a tube that supports the inside of the wall of the aorta. This helps to reduce pressure on the aneurysm. It is important to treat aortic aneurysm because a ruptured aortic aneurysm can immediately lead to death. It is estimated that around 40 percent of ruptured aneurysms die within the first 24 hours.
Endoleak is a common complication following an EVAR procedure. Endoleak occurs when the blood finds its way around the stent graft and into the aneurysm. In most cases, endoleak does not cause any symptoms and usually is only found after a follow-up visit with the surgeon right after an EVAR procedure. Endoleak can be caused by several reasons such as from the graft or from the blood vessels itself. Roughly, there are 5 types of endoleak .The most common one would be the type II (or known as type 2) which is the increased pressure in the blood vessels branching from the aorta allowing the blood back into the aneurysm sac that is low pressure. The other 4 types of endoleak are as followed:
- Type I- Leaks develop at either end of the stent graft or components overlap due to an insufficient seal.
- Type III- Leaks from defects in the stent graft such as holes in fabric or separation between the components.
- Type IV- Leaks through the pores of the stent graft.
- Type V- Known as endotension, not a leak but considered as continued enlargement of the aneurysm sac when no evidence of leak is presented.
Treatment for endoleak depends on the type of the endoleak. In general, treatment aims to prevent blood flowing into the aneurysm and cause a ruptured aneurysm. Treatment ranges from careful observation by the healthcare provider to surgery that fix the endoleak. At times, a person may be needing a new stent-graft after an endoleak treatment.
It can be concluded that endoleak in an aortic aneurysm is the most common complication following an EVAR procedure. It is important to treat endoleak because when left untreated, the EVAR procedure would be proven meaningless and a person is likely to experience a ruptured aneurysm that may lead to instant death. The best way to know if you have an aneurysm, is to get regular health screening. To reduce chances for developing aneurysm, it is best to take preventative measures such as smoking cessation and to get treatment for high blood pressure. Practising healthy lifestyles such as eating a healthy balanced meal and regular physical activity can further reduce the risk for an aneurysm. Those with high risk for aneurysm such as family history with the aneurysm disease or connective tissues disorders such as Marfan syndrome or Ehlers-Danlos syndrome, should always discuss with their healthcare provider on what they can do to avoid a ruptured aneurysm and to get regular aneurysm screening.