Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (778 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Postoperative hemorrhage from an endovascular aortic aneurysm repaired with endoluminal placement of stent grafts (endovascular aneurysm repair). It is associated with pressurization, expansion, and eventual rupture of the aneurysm.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Endoleaks; Perigraft Leak; Leak, Perigraft; Perigraft Leaks.
Where it fits in the MeSH classification
- Broader topics
- Aneurysm; Postoperative Hemorrhage
- See also
- Capillary Leak Syndrome
Related concepts
- Aortic Aneurysm
- Endovascular Aneurysm Repair
Research landscape
PubMed indexes 2,511 records tagged with the MeSH heading “Endoleak” (counts retrieved 2026-10-29). 1,064 of them (42.4%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 1,504 records.
Reviews account for 280 records (11.2%) and meta-analyses for 79. Randomized controlled trials number 14 (0.6%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 0 |
| 2000-2009 | 3 |
| 2010-2019 | 1,504 |
| 2020 onward | 1,064 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 280 | 11.2% |
| Meta-analyses | 79 | 3.1% |
| Randomized controlled trials | 14 | 0.6% |
Method: PubMed query "Endoleak"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-29.
Reading the evidence in cardiovascular medicine
Cardiovascular medicine has an unusually large body of randomized trials, so the type of outcome matters: hard clinical events such as death, heart attack and stroke carry more weight than changes in blood pressure, cholesterol or imaging markers that only predict risk. Observational studies can show associations but are confounded by age, lifestyle and other illness. Check whether a result is about prevention or treatment, the baseline risk of participants, and the absolute rather than only the relative size of any benefit.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis | 2017 | Meta-analysis Design not recorded in structured metadata | 72 | cc by PMID 28182753 · DOI · PMC5300210 |
| Secondary Endoleak Management Following TEVAR and EVAR | 2020 | Review article Design not recorded in structured metadata | 66 | cc by PMID 32778905 · DOI · PMC7649162 |
| Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT) | 2017 | Clinical trial Design not recorded in structured metadata | 34 | cc by PMID 27436027 · DOI · PMC5334388 |
| Nellix Device Failure Mechanisms Analysis on Explanted Grafts | 2026 | Research article Design not recorded in structured metadata | 3 | cc by PMID 39188181 · DOI · PMC12972096 |
Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis [1]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectivesThis systematic review and meta-analysis aims to determine the current evidence on risk factors for type II endoleaks after endovascular aneurysm repair (EVAR).
- Closing excerpt
- However, further studies are needed to analyze a number of potential risk factors.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (147 words)
ObjectivesThis systematic review and meta-analysis aims to determine the current evidence on risk factors for type II endoleaks after endovascular aneurysm repair (EVAR).Materials and methodsA systematic literature search was carried out for studies that evaluated the association of demographic, co-morbidity, and other patient-determined factors with the onset of type II endoleaks. Pooled prevalence of type II endoleaks after EVAR was updated.ResultsAmong the 504 studies screened, 45 studies with a total of 36,588 participants were included in this review. The pooled prevalence of type II endoleaks after EVAR was 22% [95% confidence interval (CI), 19%-25%]. The main factors consistently associated with type II endoleaks included age [pooled odds ratio (OR), 0.37; 95% CI, 0.31-0.43; PConclusionsClinicians can use the identified risk factors to detect and manage patients at risk of developing type II endoleaks after EVAR. However, further studies are needed to analyze a number of potential risk factors.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 28182753 · DOI · PMC5300210
Secondary Endoleak Management Following TEVAR and EVAR [2]
Abstract reading summary — source excerpts
- Opening excerpt
- Endovascular abdominal and thoracic aortic aneurysm repair and are widely used to treat increasingly complex aneurysms.
- Closing excerpt
- This chapter reviews the aetiology, significance, management strategy and techniques for different endoleak types.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (137 words)
Endovascular abdominal and thoracic aortic aneurysm repair and are widely used to treat increasingly complex aneurysms. Secondary endoleaks, defined as those detected more than 30 days after the procedure and after previous negative imaging, remain a challenge for aortic specialists, conferring a need for long-term surveillance and reintervention. Endoleaks are classified on the basis of their anatomic site and aetiology. Type 1 and type 2 endoleaks (EL1 and EL2) are the most common endoleaks necessitating intervention. The management of these requires an understanding of their mechanics, and the risk of sac enlargement and rupture due to increased sac pressure. Endovascular techniques are the main treatment approach to manage secondary endoleaks. However, surgery should be considered where endovascular treatments fail to arrest aneurysm growth. This chapter reviews the aetiology, significance, management strategy and techniques for different endoleak types.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32778905 · DOI · PMC7649162
Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT) [3]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectivesTo assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR).
- Closing excerpt
- • CT angiography is the imaging modality of choice for aortic aneurysm evaluation.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (206 words)
ObjectivesTo assess a single-phase, dual-energy computed tomography (DECT) with a split-bolus technique and reconstruction of virtual non-enhanced images for the detection of endoleaks after endovascular aneurysm repair (EVAR).MethodsFifty patients referred for routine follow-up post-EVAR CT and a history of at least one post-EVAR follow-up CT examination using our standard biphasic (arterial and venous phase) routine protocol (which was used as the reference standard) were included in this prospective trial. An in-patient comparison and an analysis of the split-bolus protocol and the previously used double-phase protocol were performed with regard to differences in diagnostic accuracy, radiation dose, and image quality.ResultsThe analysis showed a significant reduction of radiation dose of up to 42 %, using the single-acquisition split-bolus protocol, while maintaining a comparable diagnostic accuracy (primary endoleak detection rate of 96 %). Image quality between the two protocols was comparable and only slightly inferior for the split-bolus scan (2.5 vs. 2.4).ConclusionsUsing the single-acquisition, split-bolus approach allows for a significant dose reduction while maintaining high image quality, resulting in effective endoleak identification.Key points• A single-acquisition, split-bolus approach allows for a significant dose reduction. • Endoleak development is the most common complication after endovascular aortic repair (EVAR). • CT angiography is the imaging modality of choice for aortic aneurysm evaluation.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27436027 · DOI · PMC5334388
Nellix Device Failure Mechanisms Analysis on Explanted Grafts [4]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveTo understand possible reasons for poor durability of the Nellix (Endologix Inc.
- Closing excerpt
- Any suspicious conditions during the follow-up must be taken seriously and explantation should be considered.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (288 words)
ObjectiveTo understand possible reasons for poor durability of the Nellix (Endologix Inc., Irvine, USA) endovascular aneurysm sealing (EVAS) device.Materials and methods21 Nellix endoprostheses explanted for endoleaks and migration underwent visual examinations of stent structures and instrumental examinations of the polymer endobags on 4 devices. We harvested 2.0-gram polymer slices out of each of them and tested the samples in an in vitro implantation replication that included wet and dry exposures. During the wet phase, we placed samples in a beaker with saline, mimicking the filling of the endobags during implantation. An exposure to a 37°C environment with 60% humidity during the dry phase replicated the postimplantation conditions inside the aneurysmal sac.ResultsIatrogenic defects affected 16 (76%) metal stents and 20 (95%) endobags. The polymer was disintegrated owing to degradation in 15 (71%) cases. The polymer could lose more than 70% of its initial weight when partially dehydrated and regain 80% when placed in saline. We observed volume decrease and polymer fragmentation during these study phases.ConclusionsThe polymer can lose weight and volume while it dehydrates. This structural degradation of the polymer could lead to the development of endoleaks and/or migration of the device.Clinical ImpactBased on the results of previous investigations, due to possible endovascular device degradation, patients with endografts should be offered life-long surveillance, and the Nellix device is no exception. Herein we suggest polymer degradation as one of the possible reasons for the device failure. Although Nellix has been withdrawn from the market, there are numerous patients with this type of endograft. Due to its unpredictable performance in the medium and long term, these patients should be recommended enhanced life-long surveillance every 6 months. Any suspicious conditions during the follow-up must be taken seriously and explantation should be considered.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 39188181 · DOI · PMC12972096
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Type II endoleak after endovascular aneurysm repair [5]
- Research article Editor's Choice - Systematic Review and Meta-Analysis of the Outcome of Treatment for Type II Endoleak Following Endovascular Aneurysm Repair [6]
- Research article Late Rupture of Abdominal Aortic Aneurysm After Previous Endovascular Repair: A Systematic Review and Meta-analysis [7]
- Research article A Systematic Review of Proximal Neck Dilatation After Endovascular Repair for Abdominal Aortic Aneurysm [8]
- Research article Type II endoleaks [9]
- Research article Magnetic resonance imaging is more sensitive than computed tomography angiography for the detection of endoleaks after endovascular abdominal aortic aneurysm repair: a systematic review [10]
References
- Guo Q, Du X, Zhao J, Ma Y, Huang B, Yuan D, et al.. Prevalence and risk factors of type II endoleaks after endovascular aneurysm repair: A meta-analysis. . 2017. PMID 28182753 · DOI · PMC5300210
- Ameli-Renani S, Pavlidis V, Morgan RA. Secondary Endoleak Management Following TEVAR and EVAR. . 2020. PMID 32778905 · DOI · PMC7649162
- Javor D, Wressnegger A, Unterhumer S, Kollndorfer K, Nolz R, Beitzke D, et al.. Endoleak detection using single-acquisition split-bolus dual-energy computer tomography (DECT). . 2017. PMID 27436027 · DOI · PMC5334388
- Christ L, Kuntz S, Vakhitov D, Raibaut L, Neumann N, Heim F, et al.. Nellix Device Failure Mechanisms Analysis on Explanted Grafts. . 2026. PMID 39188181 · DOI · PMC12972096
- Sidloff DA, Stather PW, Choke E, Bown MJ, Sayers RD. Type II endoleak after endovascular aneurysm repair. Br J Surg. 2013. PMID 23939840 · DOI
- Ultee KHJ, Büttner S, Huurman R, Bastos Gonçalves F, Hoeks SE, Bramer WM, et al.. Editor's Choice - Systematic Review and Meta-Analysis of the Outcome of Treatment for Type II Endoleak Following Endovascular Aneurysm Repair. Eur J Vasc Endovasc Surg. 2018. PMID 30104089 · DOI
- Antoniou GA, Georgiadis GS, Antoniou SA, Neequaye S, Brennan JA, Torella F, et al.. Late Rupture of Abdominal Aortic Aneurysm After Previous Endovascular Repair: A Systematic Review and Meta-analysis. J Endovasc Ther. 2015. PMID 26286073 · DOI
- Kouvelos GN, Oikonomou K, Antoniou GA, Verhoeven EL, Katsargyris A. A Systematic Review of Proximal Neck Dilatation After Endovascular Repair for Abdominal Aortic Aneurysm. J Endovasc Ther. 2017. PMID 27974495 · DOI
- Avgerinos ED, Chaer RA, Makaroun MS. Type II endoleaks. J Vasc Surg. 2014. PMID 25175637 · DOI
- Habets J, Zandvoort HJ, Reitsma JB, Bartels LW, Moll FL, Leiner T, et al.. Magnetic resonance imaging is more sensitive than computed tomography angiography for the detection of endoleaks after endovascular abdominal aortic aneurysm repair: a systematic review. Eur J Vasc Endovasc Surg. 2013. PMID 23403221 · DOI
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-10-29.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.