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Purpose: The purpose of this study is to evaluate CO2- digital subtraction angiography (CO2-DSA) as an alternative for detection endoleak (EL) at EVAR procedure, comparing with iodinated conventional DSA (C-DSA). Materials and Methods: Thirty-seven patients with infrarenal AAA who were scheduled to undergo EVAR were enrolled in the study. All patients had both C-DSA and CO2-DSA immediately after EVAR. All patients were followed by CT over 6 months after EVAR. We evaluated the C-DSA and CO2-DSA results for the presence or absence of an EL. Identified ELs were classified by types. The sensitivity and specificity were calculated for the ability of CO2-DSA to detect ELs. We also correlated with CT findings at 6 months after EVAR. Results: C-DSA showed that 26 of the 37 patients (70%) were identified to have a total of 27 ELs (type I;4, type II;20, type III;3, type IV;0). On the other hands, CO2-DSA showed that 16 of the 37 patients (43%) were identified to have a total of 17 EL (type I;4, type II;10, type III;3, type IV;0). For the detection of high flow type ELs (type I and III) using C-DSA as the criterion standard, CO2-DSA has a sensitivity of 100% and a specificity of 100%. For the detection of type II ELs, CO2-DSA has a sensitivity of 45% and a specificity of 100%. Based on CT findings after 6 months from EVAR, 9 of 20 type II ELs identified by C-DSA (45%) progressed to persistent type II ELs. For the detection of progressed persistent type II ELs, CO2-DSA has a sensitivity of 100% and a specificity of 96%. On the other hand, C-DSA has a sensitivity of 100% and a specificity of 61%. Conclusion: CO2-DSA is reliable for prediction of persistent type II endoleaks in EVAR. CO2-DSA is alternative to C-DSA to detect the ELs at EVAR procedure. . [Copyright &y& Elsevier]