Karch et al developed an algorithm for the diagnosis and management of endoleaks from an endoluminal graft for an abdominal aortic aneurysm. The authors are from the Southern Illinois University in Springfield, Illinois.

Schedule for CT scans if no leaks are evident:

(1) 1 month after surgery

(2) at 6 months after surgery

(3) at 12 months after surgery

(4) yearly thereafter


If a leak is detected on the CT scan, then a repeat scan is done at 3 months after surgery.

• If no leak is detected, then the person follows the "no leak" CT protocol.

• If a leak is detected, then angiography is performed.


Angiographic Finding


endoleak Type I, III or IV

endovascular or surgical repair

endoleak Type II

observe the patient with a CT scan every 6 months; if the aneurysm expands, perform endovascular or surgical repair

no leak

follows the "no leaks" CT protocol


After repair, the patient undergoes the "no leaks" CT protocol.


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