CTICasesBranch artery pseudoaneurysm (blood pool) mimicking endoleak post-TEVAR
Imaging findings
CT angiogram following TEVAR for a type B aortic intramural hematoma shows a collection of contrast outside the endograft within the thrombosed aortic wall. The contrast pool was traced directly to a patent intercostal or bronchial branch artery (branch artery pseudoaneurysm), representing a stable vascular blood pool rather than a true endoleak.
Key takeaways
Branch artery pseudoaneurysms or back-bleeding from intercostal/bronchial arteries into a thrombosing aortic wall can mimic a type I or II endoleak post-TEVAR. Detailed tracking of the vessel origin (often utilizing MIP) is critical to avoid unnecessary re-intervention.
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