Use of the term endotension in the treatment of aortic aneurysm is currently controversial. Initially it was proposed to define the circumstance in which there is an enlargement of the aneurysm sac after endovascular repair without a demonstrable endoleak. The term was established with the aim of transmitting the possibility of causes other than pressure applying stress to the aneurysm wall. Twenty years have passed since the proposal of this terminology was published. The literature is reviewed with the purpose of providing an update on advances in the knowledge of the possible etiological mechanisms. The experimental studies call into question that causes other than pressure determine the increase of the aneurysm. On the basis of this review, the term `Sac Expansion Without Evident Leak´ (SEWEL) is proposed as a more accurate and precise denomination for what is aimed to be defined. Evidence suggests that the more likely mechanisms of persistent pressurization of the aneurysm sac are an unidentified endoleak (likely type I or low-flow Type II) or thrombus occluding wide and short channels that connects with the excluded aneurysm sac (at the attachment sites of the stent-graft or at the branch vessels orifices).

中文翻译：

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内张力：一个有争议的术语的二十年

使用术语内压治疗主动脉瘤目前存在争议。最初提议定义血管内修复后动脉瘤囊扩大而没有明显内漏的情况。建立该术语的目的是传达除对动脉瘤壁施加压力之外的其他原因的可能性。自从这个术语的提议发表以来，已经过去了二十年。审查文献的目的是提供有关可能病因机制知识的最新进展。实验研究质疑压力以外的原因决定了动脉瘤的增加。在这次审查的基础上，术语“无明显泄漏的囊扩张”(SEWEL) 被提议作为更准确和精确的名称来定义目标。有证据表明，动脉瘤囊持续加压的更可能机制是不明内漏（可能是 I 型或低流量 II 型）或血栓阻塞与排除的动脉瘤囊相连的宽短通道（在动脉瘤的附着部位）。支架移植物或在分支血管口）。