CTICasesStent Graft Fabric Leak post PAU Repair
Imaging findings
Initial CT angiography shows a penetrating atherosclerotic ulcer (PAU) of the descending thoracic aorta. Post-operative CTA six days after endovascular stent-graft placement shows a focal blush of contrast material directly through the mid-portion of the stent fabric into the excluded ulcer cavity, without proximal or distal endoleak.
Key takeaways
Penetrating atherosclerotic ulcers are focal aortic injuries managed with endovascular stent grafts. Follow-up imaging can demonstrate micro-leaks or contrast penetration directly through the stent fabric. This is distinct from type I or III endoleaks and may represent fabric porosity or minor graft defects that require close follow-up.
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