Endoleaks are often asymptomatic, however as flow within the aneurysm sac is at systemic or near- systemic pressure, if untreated, the aneurysm may expand and is at risk of rupture. As such aneurysm expansion following EVAR always warrants investigation for endoleak.
Endoleak may become evident intra-operatively, years down the track, or anywhere in between. Therefore lifelong imaging surveillance is necessary. This is usually performed with CT angiography.