Endoleaks following conventional open abdominal aortic aneurysm repair

Objective: to describe the complication of "endoleak" following conventiona l open abdominal aortic aneurysm (AAA) repair. Design: prospective case study. Setting: two specialist vascular surgical centres. Patients and Methods: sir patients who had successful conventional open AAA repair. Results: six patients presented with back or abdominal pain or hypotension between one and eighteen months later. An endoleak at the distal anastomosi s was noted in Jive of the cases and one endoleak at the proximal anastomos is. All sir cases were successfully repaired; two of these patients require d Dacron graft replacement, whilst in four cases only direct resuturing was needed. There was no evidence of infection. Conclusions: an endoleak is not a phenomenon confined to stent grafts. It s hould be considered in all patients who present with back or abdominal pain within eighteen months of open AAA repair. The combination of computed tom ography (CT) scan and digital subtraction angiography is most useful for pr eoperative diagnosis.