Type II endoleak following endovascular aneurysm repair (EVAR) is caused by:

• A Incomplete seal at the proximal or distal graft attachment zones, allowing antegrade flow into the sac
• B Defect in the graft fabric allowing flow through the prosthesis into the sac
• C Inadequate overlap between modular graft components causing a junction leak
• D Retrograde filling of the aneurysm sac from collateral vessels — lumbar arteries or inferior mesenteric artery ✓

Explanation

Endoleak classification: Type I — attachment zone seal failure (Ia proximal, Ib distal); Type II — retrograde flow into sac from branch vessels (IMA, lumbar arteries) — most common, usually benign; Type III — fabric defect or component junction leak; Type IV — graft porosity (rare with modern grafts); Type V — endotension (sac expansion without demonstrable leak). Type II endoleak is managed conservatively unless the sac expands >5 mm in diameter, in which case coil embolisation of the feeding vessel is performed.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.