Endotension; What Do We and Don’t We Know about This Enigmatic Complication of EVAR

Abstract Objective As the endovascular treatment of aneurysm repair continues to surge, more and more patients are being identified with endoleaks. There are five types of endoleaks. Endotension, or type V endoleak, remains controversial due to its variable definition across studies and range of proposed treatments. What do we know and not know about this rare form of endoleak? Design A review article summarizing the literature in regard to diagnosis and treatment of this rare complication after endovascular aneurysm repair. Conclusion The presence of an endoleak places patients at an increased risk for aneurysm sac enlargement and potential rupture. While additional research is essential and yet difficult to perform, we aim to provide a guide for management of this perplexing endoleak known as Endotension.