Endofugas tipo II tras tratamiento endovascular de los aneurismas de aorta abdominal: incidencia, factores predisponentes, pruebas diagnósticas, indicaciones y alternativas terapéuticas

Summary. Introduction. The lower degree of invasiveness and satisfactory short-term results of endovascular procedures has made them an attractive therapeutic alternative in the treatment of abdominal aortic aneurysms. New, previously unknown complications have appeared in conventional surgery), the most Frequent being endoleaks, with an incidence that varies between 10 to 50% of patients who are treated. Their importance lies in the fact that they can maintain the pressurisation of the sac and therefore the risk of rupture. Retrograde filling of the aneurysmal sac from a collateral artery makes type II endoleaks the most frequent subgroup (8 to 45%). Aim. To review their aetiopathogenesis and course, the imaging techniques that can be used in the follow -up, and the indications and alternatives for treatment. Development. The following are the main findings resulting from a review of the literature: most type II endoleaks are transient (33-79.9%), that is to say, they disappear spontaneously. Only a small percentage of them produce pressurisation of the aneurysmal sac and entail a risk of rupture, and these are the ones that need to be corrected. Computerised axial tomographic angiography continues to be the most widely used method of follow-up in patients who have undergone endovascular repair of abdominal aortic aneurysms. Correction of this type of endoleaks can often be carried out by means of either endovascular or scarcely invasive treatment, in which the surgical approaches and materials to be used are both specified. Conclusions. A significant increase in diameter is the most widely accepted indication for repairing a type II endoleak. Management of the different corrective techniques that are available allow it to be performed on a frequent basis using endovascular or scarcely invasive methods. [ANGIOLOGÍA 2009; 61: 195-204]