Successful endovascular aortic aneurysm repair (EVAR) is often defined as complete exclusion of blood flow within the aneurysm sac. Perigraft flow, also known as endoleak, is the most common complication following EVAR. Attachment site related endoleaks (type 1) are generally considered to warrant some form of intervention due to the belief that they represent a risk for future rupture. Management of type 11 endoleaks, also known as branch or collateral endoleaks, is more controversial. Some advocate a policy of watchful-waiting whereas others treat all type 11 endoleaks as soon as they are discovered. The following review explores the controversies pertaining to the management, diagnosis and surveillance imaging, and treatment of type 11 endoleaks.
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