CTICasesType 2 Endoleak after TEVAR
Imaging findings
A patient presented with a leaking, ruptured descending thoracic aortic aneurysm and extensive mediastinal hematoma, treated with a thoracic stent-graft. A post-stent endoleak near the caudal extent of the graft was described as probable type 1b, prompting placement of an additional inferior stent covering the celiac origin. The endoleak persisted despite the extra stent and did not enlarge, with filling appearing to arise from a lumbar or intercostal branch vessel.
Key takeaways
An endoleak persisting after extending a thoracic stent-graft, without enlargement and with filling from a branch vessel such as a lumbar or intercostal artery, indicates a type 2 endoleak rather than a type 1b. This distinction matters for management, since type 2 endoleaks are typically observed expectantly whereas type 1 endoleaks require intervention, so confidently characterizing the leak type guides treatment.
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