16960 Endoleak
Informed by recognized medical guidance
Overview
An endoleak is a small leak of blood that can develop after a procedure to fix a bulging blood vessel (aneurysm). It happens when blood flows back into the old aneurysm sac through or around the mesh tube (stent graft) used to reinforce it.
Key facts
- Endoleaks are a known complication after endovascular aneurysm repair (EVAR).
- Most endoleaks cause no symptoms and are found on routine follow-up scans.
- Not all endoleaks need treatment — some seal themselves over time.
Yes, it is quite common. About 1 in 4 people who have had this repair will develop some kind of endoleak at some point. Not all endoleaks are dangerous, and many need no treatment.
It affects people who have had an operation called EVAR (endovascular aneurysm repair) for an abdominal aortic aneurysm.
Symptoms
- Sudden, severe pain in your belly or back
- Feeling dizzy, lightheaded, or fainting
- Cold, clammy skin or rapid heart rate — these can be signs of a ruptured aneurysm
- ⚠New or worsening pain in your belly or back that does not go away
- ⚠Fever, chills, or signs of infection around the surgical site
- ⚠If you have a follow-up scan scheduled and notice any new symptoms before it
Common symptoms
- Most endoleaks cause no symptoms at all.
- They are usually found on regular follow-up scans.
Symptoms in children
- Endoleaks do not typically affect children.
Symptoms in older adults
- Older adults may not notice any symptoms, but should not ignore new back or belly pain.
Causes
Main causes
- Blood leaking around the ends of the mesh tube
- Blood flowing into the aneurysm from small branches of the blood vessel
- A tear in the mesh tube itself
- Porosity of the mesh tube — tiny gaps that let blood seep through
Risk factors
- Having a large aneurysm before repair
- Irregular shape of the aneurysm
- Younger age at the time of repair
- Continued smoking after surgery
- Not attending regular follow-up scans
When to see a doctor
See a doctor urgently if:
- If you have sudden severe belly or back pain, fainting, or signs of shock, call your local emergency number immediately.
Book a routine appointment if:
- Keep all scheduled follow-up scans and appointments.
- Contact your vascular team if you have questions about your endoleak or treatment plan.
Diagnosis
Most endoleaks are found on routine imaging scans after EVAR.
Tests that may be done
- CT scan (computed tomography)
- Ultrasound scan (duplex ultrasound)
What to expect at your appointment
You will lie still while the scanner takes pictures. The test is painless. Your doctor will compare the images with previous scans to see if the leak is growing or changing.
Treatment
Treatment depends on the type and size of the endoleak. Some need no treatment; others need a small procedure to seal the leak.
Self-care at home
- Attend all follow-up appointments and scans.
- Stop smoking — it helps your blood vessels heal.
- Keep blood pressure under control with a healthy lifestyle.
Medical treatments
If treatment is needed, it is usually a minimally invasive procedure. The surgeon may insert another small mesh tube, or use special material to block the leak. There are no specific medicines to cure an endoleak.
When is surgery considered?
Surgery may be needed if the endoleak causes the aneurysm to grow, or if it is a type that has a high risk of rupture.
Living with this condition
For most people, an endoleak does not change daily life. You can carry on with normal activities unless your doctor advises otherwise.
Lifestyle tips
- Not smoking
- Staying physically active within comfort
- Taking any prescribed medicines for blood pressure or cholesterol
Diet and exercise
Eat a balanced diet with fruits, vegetables, whole grains, and lean protein. Gentle exercise like walking is usually fine, but check with your surgeon before starting a new activity.
Mental health and emotional wellbeing
Being told you have an endoleak can feel worrying. Many people feel anxious about their scan results. That is normal, and talking to your care team or a counsellor can help.
Prevention
You cannot completely prevent an endoleak, but you can lower your risk by attending follow-up scans, not smoking, and keeping your blood pressure healthy.
Complications
If left untreated
- If a high-risk endoleak is not treated, it can put pressure on the aneurysm sac and make it grow.
- This can eventually lead to a rupture, which is life-threatening.
Long-term outlook
The outlook is good. Most endoleaks are mild, and anyone with a significant endoleak can be treated successfully. Your medical team will watch you closely, and many people live normal, healthy lives after the procedure.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Related conditions
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.