Part 4/Chapter 21/9-min read

Endovascular Aneurysm Repair, Iliac Branch Devices, Endoleaks, and Post-Endovascular Aneurysm Repair Surveillance

Endovascular aneurysm repair as an anatomic operation before it is a device operation: proximal neck, iliac landing zones, pelvic perfusion, and durable seal. The chapter frames standard EVAR candidacy, iliac branch devices, endoleak classification and management, and post-EVAR surveillance.

Edited by Tal M. Hörer MD, PhD · David T. McGreevy MD, PhD·Version 1 · Last published ·5 sections · 41 references

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Definition and presentation

Endovascular repair () aims to exclude an abdominal aortic aneurysm from the systemic circulation while preserving clinically important pelvic and lower-limb perfusion. All patients with aortic aneurysmal disease receive baseline medical management, which includes blood-pressure control, statin therapy, and smoking cessation. Elective repair is considered at a maximum aneurysm diameter of 5.5 cm or more in men and 5.0 cm or more in women, or for growth exceeding 10 mm per year . For patients with an appropriate threshold for repair, standard infrarenal EVAR candidacy is determined by the proximal neck length, angulation, and wall quality, alongside the iliac landing zone diameter. Proximal-neck length is a device-specific minimum, not a permitted range of only 10–15 mm. For example, the GORE EXCLUDER AAA European labeling specifies at least 15 mm, whereas the manufacturer's public GORE EXCLUDER Conformable indication summary specifies at least 10 mm, with different associated diameter and angulation requirements. Eligibility must satisfy the complete current regional instructions for the chosen model, including distal seal and access requirements . A short, angulated, or highly diseased neck increases the risk of proximal seal failure and type Ia endoleak, which is associated with sac expansion and reintervention . A standard device should not be forced into unsuitable anatomy; assess open repair, an appropriate complex endovascular solution or non-intervention according to anatomy and expected benefit. Patients with prohibitive operative risk, limited life expectancy, or incompatible care goals are managed by deliberate non-intervention rather than surgical or endovascular repair.

Endoleak classification and surveillance

Post-EVAR surveillance tracks the presence of endoleak and the trajectory of the aneurysm sac . Surveillance is lifelong because the early advantage of EVAR erodes with time. EVAR trial 1 at 15 years showed a perioperative survival benefit that was lost within the first few years, and beyond eight years EVAR patients had higher aneurysm-related mortality, with secondary sac rupture contributing to that late excess . A stable or shrinking sac indicates technical success and permits lower-risk surveillance pathways. Baseline angiography is obtained within 30 days of EVAR. SVS 2018 recommends baseline contrast CT and color duplex within the first month. If there is no endoleak or sac enlargement, imaging is repeated at 12 months using CT or duplex, followed by annual duplex when feasible; a type II endoleak at one month prompts CT and duplex at six months. Other abnormalities require a finding-specific response rather than automatic assignment to a six-month interval. ESVS 2024 stratifies by risk after the baseline CT angiography: the lowest-risk patients, with adequate seal of 10 mm or more of proximal and distal overlap and no endoleak, may have imaging deferred as far as 5 years, while the remainder move to annual duplex or contrast-enhanced ultrasound with periodic CT angiography. Sac expansion indicates persistent systemic pressurisation. Diagnosing an endoleak

Use duplex to assess sac diameter and flow, and to evaluate seal zones, component integrity and the source of sac perfusion. A dedicated CTA examination can include unenhanced, arterial and delayed acquisitions according to the diagnostic question. A negative arterial phase does not exclude slow filling. With unexplained sac enlargement or an uncertain leak type, consider contrast-enhanced ultrasound (CEUS) or time-resolved dynamic CTA before attributing the finding to type II endoleak or endotension .

CEUS and SonoVue

CEUS displays the timing and direction of sac enhancement during continuous low-mechanical-index imaging. Sulfur hexafluoride microbubbles such as SonoVue avoid iodinated contrast and ionizing radiation, and prolonged observation can reveal low-flow leaks missed on a fixed CT acquisition. In a small selected study, CEUS detected delayed enhancement in ten enlarging sacs with negative duplex and biphasic CT; this was problem-solving evidence, not an unselected surveillance accuracy estimate. Bowel gas, body habitus and operator experience can limit the examination; CEUS does not replace CT assessment of all structural device complications .

The EMA product information does not explicitly list post-EVAR endoleak detection as an indication. Use must follow the applicable local authorization and contrast policy. Check contraindications and hypersensitivity risk, use trained personnel with emergency support, and observe patients for at least 30 minutes after administration; the formulation contains polyethylene glycol .

Dynamic CTA

Dynamic CTA samples contrast passage over multiple time points to distinguish early seal-related filling from delayed branch inflow and to map feeding vessels. In a selected 16-patient series, it classified 11 endoleaks that standard CTA had left undefined. This supports a targeted problem-solving role, not routine dynamic scanning for every EVAR follow-up. Temporal sampling, contrast timing and radiation exposure vary with the scanner and protocol .

Postoperative sac pressurisation is defined by endoleak class, which links the imaging finding to the source of persistent flow :

  • Type Ia: Proximal seal failure.
  • Type Ib: Distal seal failure.
  • Type II: Retrograde branch flow into the sac.
  • Type III: Graft junction separation or fabric failure.
  • Type IV: Graft porosity (predominantly historical).
  • Type V: Endotension, a diagnosis of exclusion when the sac expands without a visualised leak.

Treatment decisions and reintervention

Intervention targets the specific mechanism of repair failure. Structural exclusion failures, including type Ia, Ib, and III endoleaks, require definitive correction with endovascular adjuncts or open conversion. Type II endoleak is the most common finding after EVAR, and detection far outnumbers clinically meaningful sac growth. A stable sac is therefore watched, while an expanding sac is treated by transarterial or translumbar embolisation of the feeding branches, escalating to relining or open conversion if embolisation fails. Clinically significant sac expansion is an increase of 5 mm or more in maximum aneurysm diameter from the smallest prior post-EVAR measurement . ESVS 2024 recommends considering type II reintervention when the sac grows 10 mm or more, leaving the 5 to 10 mm band as the zone of centre-level variation. Emergency presentations, including post-EVAR rupture, acute graft infection, or a threatened limb, supersede elective algorithms and mandate an urgent endovascular or open intervention pathway.

Post-EVAR management and reintervention triggers

  • Medical management

    Clinical finding or trigger
    Aneurysmal disease baseline
    Recommended action
    Blood-pressure control, statin, and smoking cessation
    Citation

  • Proximal seal failure

    Clinical finding or trigger
    Type Ia endoleak with sac expansion
    Recommended action
    Proximal cuffs, sealing devices, or open conversion
    Citation

  • Distal seal failure

    Clinical finding or trigger
    Type Ib endoleak
    Recommended action
    Distal extension or landing zone revision
    Citation

  • Retrograde branch flow

    Clinical finding or trigger
    Type II endoleak without expansion
    Recommended action
    Continued imaging surveillance
    Citation

  • Retrograde branch flow

    Clinical finding or trigger
    Type II endoleak with sac expansion
    Recommended action
    Transarterial or translumbar embolisation of the feeding branches; reline or convert to open repair if embolisation fails
    Citation

  • Device failure

    Clinical finding or trigger
    Type III endoleak
    Recommended action
    Endovascular repair of fabric or graft junction
    Citation

  • No intervention

    Clinical finding or trigger
    Prohibitive risk or limited life expectancy
    Recommended action
    Deliberate non-intervention and supportive care
    Citation

  • Emergency

    Clinical finding or trigger
    Rupture, severe infection, or threatened limb
    Recommended action
    Urgent endovascular or open intervention
    Citation

Reintervention planning follows a stepwise assessment:

  1. Confirm patient suitability for reintervention versus the deliberate no-intervention pathway.
  2. Confirm the presence or absence of endoleak and classify its flow source.
  3. Assess sac dynamics as stable, shrinking, or expanding.
  4. Treat type Ia, Ib, and III endoleaks as mechanical failures requiring specific endovascular adjuncts or open conversion.
  5. Treat an expanding type II endoleak by embolisation of the feeding branches, reserving relining or open conversion for embolisation failure; watch a stable sac.
  6. Evaluate the continued patency and seal of any preserved iliac pathways.
  7. Escalate to urgent intervention for emergency rupture or infection outside the elective framework.

Iliac branch and pelvic perfusion management

Common iliac aneurysm extension necessitates a choice among iliac branch preservation, hypogastric embolisation, or alternative distal adjuncts such as bell-bottom techniques. Iliac branch devices preserve flow to at least one internal iliac artery and are associated with a reduction in buttock compared with routine hypogastric exclusion, while maintaining acceptable technical success . Buttock claudication follows internal iliac embolisation or coverage in roughly 28% of patients, with new erectile dysfunction reported in up to 46% , against a side preserved by an iliac branch device, which returned about 95% internal iliac limb patency and high freedom from ipsilateral buttock claudication at 5 years. In bilateral iliac disease, preserving at least one internal iliac artery is the primary planning objective, and anatomical suitability dictates the specific side selected for preservation.

Fenestrated iliac limbs

Manufacturer-customized fenestrated iliac limbs are another reported option when conventional iliac branch devices will not fit. Mafeld and colleagues described two high-open-risk patients with inadequate space for conventional iliac branches: three customized fenestrated limbs preserved three internal iliac arteries, with no endoleak reported in the immediate result. This small feasibility report does not establish comparative durability or interchangeability with standard iliac branch devices. It concerns manufacturer-customized devices, not unpublished local experience or automatic authorization of physician modification .

Areas of controversy

The limits of standard EVAR outside instructions for use remain a subject of debate, particularly regarding whether hostile neck anatomy is safely managed with standard-EVAR adjuncts or mandates fenestrated and branched repair . The exact threshold for type II endoleak intervention is not uniformly established, leading to centre-driven variation in whether to treat early sac expansion or employ pre-emptive branch embolisation . Finally, while ultrasound-based surveillance reduces contrast exposure, its reliance on local operator expertise limits universal adoption over computed tomography angiography .

Further reading

  • Pre-operative Aortic Neck Characteristics and Post-operative Sealing Zone as Predictors of Type 1a Endoleak and Migration After Endovascular Aneurysm Repair: A Systematic Review and Meta-Analysis. (2022). Neck and sealing-zone factors associated with endoleak or migration.
  • Editor's Choice - Meta-Analysis of Compliance with Endovascular Aneurysm Repair Surveillance: The EVAR Surveillance Paradox. (2023). EVAR surveillance adherence evidence.

References

  1. 1.
    Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. 2024.
    PubMed-indexed articleClinical practice guideline2024

    Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms. 2024. doi:10.1016/j.ejvs.2023.11.002.

    PubMedDOI
  2. 2.
    The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. 2018.
    PubMed-indexed articleClinical practice guideline2018

    The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm. 2018. doi:10.1016/j.jvs.2017.10.044.

    PubMedDOI
  3. 3.
    Pre-operative Aortic Neck Characteristics and Post-operative Sealing Zone as Predictors of Type 1a Endoleak and Migration After Endovascular Aneurysm Repair: A Systematic Review and Meta-Analysis. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2022.
    PubMed-indexed articleMeta-analysis / systematic review2022

    Pre-operative Aortic Neck Characteristics and Post-operative Sealing Zone as Predictors of Type 1a Endoleak and Migration After Endovascular Aneurysm Repair: A Systematic Review and Meta-Analysis. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2022. doi:10.1016/j.ejvs.2022.08.017.

    PubMedDOI
  4. 4.
    Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study. The Journal of cardiovascular surgery. 2024.
    PubMed-indexed articleClinical practice guideline2024

    Insight from an Italian Delphi Consensus on EVAR feasibility outside the instruction for use: the SAFE EVAR Study. The Journal of cardiovascular surgery. 2024. doi:10.23736/s0021-9509.23.12906-5.

    PubMedDOI
  5. 5.
    Type IIIb endoleak after elective endovascular aneurysm repair: a systematic review. The Journal of cardiovascular surgery. 2020.
    PubMed-indexed articleMeta-analysis / systematic review2020

    Type IIIb endoleak after elective endovascular aneurysm repair: a systematic review. The Journal of cardiovascular surgery. 2020. doi:10.23736/s0021-9509.18.10446-0.

    PubMedDOI
  6. 6.
    Outcomes of endovascular treatment of endoleak type Ia after EVAR: a systematic review of the literature. The Journal of cardiovascular surgery. 2019.
    PubMed-indexed articleMeta-analysis / systematic review2019

    Outcomes of endovascular treatment of endoleak type Ia after EVAR: a systematic review of the literature. The Journal of cardiovascular surgery. 2019. doi:10.23736/s0021-9509.19.10854-3.

    PubMedDOI
  7. 7.
    Systematic Review and Meta-Analysis of the Outcome of Different Treatments for Type 1a Endoleak After EVAR. Annals of vascular surgery. 2019.
    PubMed-indexed articleMeta-analysis / systematic review2019

    Systematic Review and Meta-Analysis of the Outcome of Different Treatments for Type 1a Endoleak After EVAR. Annals of vascular surgery. 2019. doi:10.1016/j.avsg.2019.03.032.

    PubMedDOI
  8. 8.
    Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature. Biomedicines. 2022.
    PubMed-indexed articleMeta-analysis / systematic review2022

    Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature. Biomedicines. 2022. doi:10.3390/biomedicines10061442.

    PubMedDOI
  9. 9.
    Editor's Choice - Meta-Analysis of Compliance with Endovascular Aneurysm Repair Surveillance: The EVAR Surveillance Paradox. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2023.
    PubMed-indexed articleMeta-analysis / systematic review2023

    Editor's Choice - Meta-Analysis of Compliance with Endovascular Aneurysm Repair Surveillance: The EVAR Surveillance Paradox. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2023. doi:10.1016/j.ejvs.2022.10.033.

    PubMedDOI
  10. 10.
    Follow up Imaging Protocols after Endovascular Aneurysm Repair: Results of the International FOREVAR Survey. EJVES vascular forum. 2025.
    PubMed-indexed article2025

    Follow up Imaging Protocols after Endovascular Aneurysm Repair: Results of the International FOREVAR Survey. EJVES vascular forum. 2025. doi:10.1016/j.ejvsvf.2025.07.005.

    PubMedDOI
  11. 11.
    Best Practice Guidelines: Imaging Surveillance After Endovascular Aneurysm Repair. AJR. American journal of roentgenology. 2020.
    PubMed-indexed articleClinical practice guideline2020

    Best Practice Guidelines: Imaging Surveillance After Endovascular Aneurysm Repair. AJR. American journal of roentgenology. 2020. doi:10.2214/ajr.19.22197.

    PubMedDOI
  12. 12.
    Meta-analysis of the accuracy of contrast-enhanced ultrasound for the detection of endoleak after endovascular aneurysm repair. Journal of vascular surgery. 2019.
    PubMed-indexed articleMeta-analysis / systematic review2019

    Meta-analysis of the accuracy of contrast-enhanced ultrasound for the detection of endoleak after endovascular aneurysm repair. Journal of vascular surgery. 2019. doi:10.1016/j.jvs.2018.07.044.

    PubMedDOI
  13. 13.
    Colour Duplex and/or Contrast-Enhanced Ultrasound Compared with Computed Tomography Angiography for Endoleak Detection after Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis. Journal of clinical medicine. 2022.
    PubMed-indexed articleMeta-analysis / systematic review2022

    Colour Duplex and/or Contrast-Enhanced Ultrasound Compared with Computed Tomography Angiography for Endoleak Detection after Endovascular Abdominal Aortic Aneurysm Repair: A Systematic Review and Meta-Analysis. Journal of clinical medicine. 2022. doi:10.3390/jcm11133628.

    PubMedDOI
  14. 14.
    Diagnostic accuracy of microvascular flow imaging ultrasound for endoleak detection after endovascular aortic aneurysm repair: a systematic review and meta-analysis. Polish journal of radiology. 2024.
    PubMed-indexed articleMeta-analysis / systematic review2024

    Diagnostic accuracy of microvascular flow imaging ultrasound for endoleak detection after endovascular aortic aneurysm repair: a systematic review and meta-analysis. Polish journal of radiology. 2024. doi:10.5114/pjr/190502.

    PubMedDOI
  15. 15.
    Endoleaks after EVAR and TEVAR: indications for treatment and techniques. The Journal of cardiovascular surgery. 2014.
    PubMed-indexed article2014

    Endoleaks after EVAR and TEVAR: indications for treatment and techniques. The Journal of cardiovascular surgery. 2014. PMID:24796903.

    PubMed
  16. 16.
    Type II endoleaks. Journal of vascular surgery. 2014.
    PubMed-indexed article2014

    Type II endoleaks. Journal of vascular surgery. 2014. doi:10.1016/j.jvs.2014.07.100.

    PubMedDOI
  17. 17.
    Type II endoleaks: challenges and solutions. Vascular health and risk management. 2016.
    PubMed-indexed article2016

    Type II endoleaks: challenges and solutions. Vascular health and risk management. 2016. doi:10.2147/vhrm.s81275.

    PubMedDOI
  18. 18.
    Type II endoleaks: when and how. The Journal of cardiovascular surgery. 2017.
    PubMed-indexed article2017

    Type II endoleaks: when and how. The Journal of cardiovascular surgery. 2017. doi:10.23736/s0021-9509.17.10072-8.

    PubMedDOI
  19. 19.
    Review of Type III Endoleaks. Seminars in interventional radiology. 2020.
    PubMed-indexed article2020

    Review of Type III Endoleaks. Seminars in interventional radiology. 2020. doi:10.1055/s-0040-1715874.

    PubMedDOI
  20. 20.
    Editor's Choice - Systematic Review and Meta-Analysis of the Outcome of Treatment for Type II Endoleak Following Endovascular Aneurysm Repair. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2018.
    PubMed-indexed articleMeta-analysis / systematic review2018

    Editor's Choice - Systematic Review and Meta-Analysis of the Outcome of Treatment for Type II Endoleak Following Endovascular Aneurysm Repair. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2018. doi:10.1016/j.ejvs.2018.06.009.

    PubMedDOI
  21. 21.
    A Systematic Review and Pooled Meta-Analysis on the Incidence and Temporal Occurrence of Type II Endoleak Following an Abdominal Aortic Aneurysm Repair. Annals of vascular surgery. 2021.
    PubMed-indexed articleMeta-analysis / systematic review2021

    A Systematic Review and Pooled Meta-Analysis on the Incidence and Temporal Occurrence of Type II Endoleak Following an Abdominal Aortic Aneurysm Repair. Annals of vascular surgery. 2021. doi:10.1016/j.avsg.2021.01.083.

    PubMedDOI
  22. 22.
    A systematic review of the current status of interventions for type II endoleak after EVAR for abdominal aortic aneurysms. International journal of surgery (London, England). 2021.
    PubMed-indexed articleMeta-analysis / systematic review2021

    A systematic review of the current status of interventions for type II endoleak after EVAR for abdominal aortic aneurysms. International journal of surgery (London, England). 2021. doi:10.1016/j.ijsu.2021.106138.

    PubMedDOI
  23. 23.
    An updated systematic review and meta-analysis of pre-emptive aortic side branch embolization to prevent type II endoleaks after endovascular aneurysm repair. Journal of vascular surgery. 2023.
    PubMed-indexed articleMeta-analysis / systematic review2023

    An updated systematic review and meta-analysis of pre-emptive aortic side branch embolization to prevent type II endoleaks after endovascular aneurysm repair. Journal of vascular surgery. 2023. doi:10.1016/j.jvs.2022.11.042.

    PubMedDOI
  24. 24.
    Understanding Type II Endoleak: A Harmless Imaging Finding or a Silent Threat? Journal of clinical medicine. 2024.
    PubMed-indexed articleReview2024

    Understanding Type II Endoleak: A Harmless Imaging Finding or a Silent Threat? Journal of clinical medicine. 2024. doi:10.3390/jcm13144250.

    PubMedDOI
  25. 25.
    Using bilateral iliac branch devices for endovascular iliac aneurysm repair. ANZ journal of surgery. 2011.
    PubMed-indexed article2011

    Using bilateral iliac branch devices for endovascular iliac aneurysm repair. ANZ journal of surgery. 2011. doi:10.1111/j.1445-2197.2011.05710.x.

    PubMedDOI
  26. 26.
    Internal Iliac Aneurysm Repair Outcomes Using a Modification of the Iliac Branch Graft. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2015.
    PubMed-indexed article2015
    PubMed
  27. 27.
    Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. Annals of vascular diseases. 2017.
    PubMed-indexed article2017

    Outcomes of Extended Endovascular Aortic Repair for Aorto-Iliac Aneurysm with Internal Iliac Artery Occlusion. Annals of vascular diseases. 2017. doi:10.3400/avd.oa.17-00089.

    PubMedDOI
  28. 28.
    Internal iliac artery preservation outcomes of endovascular aortic repair for common iliac aneurysm: iliac branch device versus crossover chimney technique. Heart and vessels. 2021.
    PubMed-indexed article2021

    Internal iliac artery preservation outcomes of endovascular aortic repair for common iliac aneurysm: iliac branch device versus crossover chimney technique. Heart and vessels. 2021. doi:10.1007/s00380-020-01678-x.

    PubMedDOI
  29. 29.
    Solitary iliac branch endoprosthesis placement for iliac artery aneurysms. Journal of vascular surgery. 2022.
    PubMed-indexed article2022

    Solitary iliac branch endoprosthesis placement for iliac artery aneurysms. Journal of vascular surgery. 2022. doi:10.1016/j.jvs.2021.10.005.

    PubMedDOI
  30. 30.
    External iliac artery extension causes greater aneurysm sac regression than the bell-bottom technique or iliac branch endoprosthesis for repair of concomitant infrarenal aortic and iliac artery aneurysm. Journal of vascular surgery. 2022.
    PubMed-indexed article2022

    External iliac artery extension causes greater aneurysm sac regression than the bell-bottom technique or iliac branch endoprosthesis for repair of concomitant infrarenal aortic and iliac artery aneurysm. Journal of vascular surgery. 2022. doi:10.1016/j.jvs.2021.12.062.

    PubMedDOI
  31. 31.
    Iliac branch device to treat type Ib endoleak with a brachial access or an "up-and-over" transfemoral technique. Journal of vascular surgery. 2022.
    PubMed-indexed article2022

    Iliac branch device to treat type Ib endoleak with a brachial access or an "up-and-over" transfemoral technique. Journal of vascular surgery. 2022. doi:10.1016/j.jvs.2022.06.025.

    PubMedDOI
  32. 32.
    Five-year outcomes from a prospective, multicenter study of endovascular repair of iliac artery aneurysms using an iliac branch device. Journal of vascular surgery. 2023.
    PubMed-indexed article2023

    Five-year outcomes from a prospective, multicenter study of endovascular repair of iliac artery aneurysms using an iliac branch device. Journal of vascular surgery. 2023. doi:10.1016/j.jvs.2022.07.006.

    PubMedDOI
  33. 33.
    Five-year outcomes for bell bottom, iliac branch endoprosthesis, and coil and cover approaches from the GREAT registry. Journal of vascular surgery. 2024.
    PubMed-indexed article2024

    Five-year outcomes for bell bottom, iliac branch endoprosthesis, and coil and cover approaches from the GREAT registry. Journal of vascular surgery. 2024. doi:10.1016/j.jvs.2024.01.212.

    PubMedDOI
  34. 34.
    Patel R, Sweeting MJ, Powell JT, Greenhalgh RM; EVAR trial investigators. Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet. 2016;388(10058):2366-2374.
    PubMed-indexed article2016

    Patel R, Sweeting MJ, Powell JT, Greenhalgh RM; EVAR trial investigators. Endovascular versus open repair of abdominal aortic aneurysm in 15-years' follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial. Lancet. 2016;388(10058):2366-2374. doi:10.1016/S0140-6736(16)31135-7.

    PubMedDOI
  35. 35.
    Rayt HS, Bown MJ, Lambert KV, Fishwick NG, McCarthy MJ, London NJM, Sayers RD. Buttock claudication and erectile dysfunction after internal iliac artery embolization in patients prior to endovascular aortic aneurysm repair. Cardiovasc Intervent Radiol. 2008;31(4):728-734.
    PubMed-indexed article2008

    Rayt HS, Bown MJ, Lambert KV, Fishwick NG, McCarthy MJ, London NJM, Sayers RD. Buttock claudication and erectile dysfunction after internal iliac artery embolization in patients prior to endovascular aortic aneurysm repair. Cardiovasc Intervent Radiol. 2008;31(4):728-734. doi:10.1007/s00270-008-9319-3.

    PubMedDOI
  36. 36.
    GORE EXCLUDER AAA Endoprosthesis: European indication and anatomical criteria Current public label summary checked 2026-09-20.
    No stable evidence link
    goremedical.com2026
    Source
  37. 37.
    GORE EXCLUDER Conformable AAA Endoprosthesis: indication and anatomical criteria Current public label summary checked 2026-09-20.
    No stable evidence link
    goremedical.com2026
    Source
  38. 38.
    Abdominal Aortic Aneurysm: Contrast-enhanced US for Missed Endoleaks after Endoluminal Repair 2004.
    PubMed-indexed article2004

    Abdominal Aortic Aneurysm: Contrast-enhanced US for Missed Endoleaks after Endoluminal Repair 2004. doi:10.1148/radiol.2331031767.

    PubMedDOISource
  39. 39.
    Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature 2023-02-21.
    PubMed-indexed article2023

    Dynamic Computed Tomography Angiography as Imaging Method for Endoleak Classification after Endovascular Aneurysm Repair: A Case Series and Systematic Review of the Literature 2023-02-21. doi:10.3390/diagnostics13050829.

    PubMedDOISource
  40. 40.
    SonoVue: EPAR product information EMA product information updated 2026-03-20.
    EMA2026
    Source
  41. 41.
    Iliac Fenestration - An Alternative Endovascular Option for Common Iliac Aneurysms 2019-10; online 2019-05-08.
    PubMed-indexed article2019

    Iliac Fenestration - An Alternative Endovascular Option for Common Iliac Aneurysms 2019-10; online 2019-05-08. doi:10.1016/j.avsg.2019.02.044.

    PubMedDOI

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