In which scenario is a Type 5 endoleak typically treated?

A Type 5 endoleak, also known as a type caused by endotension, is a unique scenario in the context of endovascular aneurysm repair (EVAR). This type of endoleak is characterized by persistent pressure inside the aneurysm sac despite the absence of a visible blood flow communication from the aorta to the sac. Essentially, the aneurysm sac may remain stable, but the pressure is high enough to potentially lead to complications or ruptures.

When a Type 5 endoleak is identified, it rarely leads to a definitive treatment response under typical conditions like certain other Types of endoleaks might (such as Types 1 or 2). Instead, if the endoleak causes significant changes, particularly an increase in aneurysm size or if there are other concerning symptoms, treatment becomes crucial. Given its complexities and potential dangers, the standard approach for resolving a Type 5 endoleak generally involves open surgical intervention. This is the most effective way to mitigate the risks associated with high-pressure scenarios within the aneurysm sac.

Monitoring without treatment is usually not appropriate when there are indications of increased pressure that could lead to complications. While some endoleaks can be observed, Type 5's nature often necessitates a more aggressive