Open repair of type Ia endoleak in the aortic arch: three tailored approaches

Endoleaks are an important complication following hybrid thoracic endovascular aortic repair (TEVAR) with an incidence ranging from 20% to 25% (1,2). There are five different types of endoleaks, which are classified based on the source of vessels that cause the inflow into the aneurysm sac (3). Type I endoleaks (EL-I) occur at either the proximal (Ia) or distal (Ib) attachment sites and can be seen during insertion of the initial stent graft or during a follow-up surveillance imaging exam.