Aortic aneurysm endovascular treatment with the parallel graft technique from the aortic arch to the iliac axis.

Background: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single-center experience.

Methods: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique.

Proximal Embolic Protection Devices in Complicated Carotid Artery Stenting.

The most frequent complication during carotid artery stenting (CAS) is intraoperative distal embolization. Three categories of embolic protection devices (EPDs) are routinely used through a transfemoral or transcervical approach: distal occlusion devices, distal EPDs with flow preservation using filters, and the proximal occlusive protective systems. We report the case of the internal carotid artery (ICA) plaque rupture during CAS using a proximal EPD (the Mo.

Extra-Anatomic Revascularization of Extensive Coral Reef Aorta.

Background: Coral reef aorta (CRA) is a rare, potential lethal disease of the visceral aorta as it can cause visceral and renal infarction. Various surgical approaches have been proposed for the CRA treatment. The purpose of this article is to report different extensive extra-anatomic CRA treatment modalities tailored on the patients' clinical and anatomic presentation.

Laparoscopic Transarterial Embolization of Type II Endoleak after Branched/Fenestrated Thoracoabdominal Aortic Aneurysm Endovascular Repair.

Type II endoleak is the most frequent procedure-related complication during endovascular aneurysm exclusion. Actually, there is little controversy in the management of type I and III endoleak, while type II endoleak still generates conflicting reports about their timing and type of treatment. Currently, the intervention is needed only in case of sac enlargement but not in case of persistent endoleak alone.

Percutaneous Embolization of Delayed External Carotid Artery Pseudoaneurysm Eight Years after Partial Parathyroidectomy.

External carotid artery pseudoaneurysm (ECAP) is very rare. The usual mechanism is trauma or iatrogenic. We report a case of a patient with an asymptomatic, chronic ECAP secondary to partial parathyroidectomy.

Complicated Fenestrated Endovascular Repair of a Pararenal Aortic Aneurysm.

We report the case of a 77-year-old man treated with a custom-made fenestrated endograft for pararenal aortic aneurysm repair. Fenestrations for the superior mesenteric and both the renal arteries and augmented anterior valley and/or scallop for the celiac trunk were performed. The procedure was complicated by the superior mesenteric artery stent-graft entrapment from the endograft delivery system release wires and total dislodgement into the endograft main body.

Seven-Year Approach Evolution of the Aortoiliac Occlusive Disease Endovascular Treatment.

Background: Endovascular treatment is now considered the first-line therapy for the aortoiliac occlusive disease (AIOD). We report our experience with the total endovascular treatment of infrarenal and pararenal aortoiliac occlusions and the 7-year approach evolution.

Methods: A total of 22 patients underwent total endovascular treatment of AIOD from January 2008 to September 2014.

Hybrid Endovascular Solutions for Supra-Aortic Vessels Extra-Anatomic Bypass Infection.

The use of extra-anatomic bypasses for the hybrid repair of thoracic aortic pathologies should consider the risk of vascular graft infection. Graft infections at cervical level are extremely rare and are associated with high mortality and morbidity rates. We report 2 cases of infected extra-anatomic bypasses for supra-aortic vessels debranching treated with a hybrid approach: re-extra-anatomical bypass with the Viabahn Open Revascularization Technique (VORTEC) in the first patient and the EndoVAC approach in the second case.

Endovascular repair of a proximal ilio-iliac arterio-venous fistula and distal pseudoaneurysm of the hypogastric artery 23 years after penetrating trauma.

We report the treatment of a proximal ilio-iliac arterio-venous fistula and distal omolateral hypogastric artery pseudoaneurysm 23 years after incurring a gunshot wound in a 43-year old man presenting with lower back pain. No cardiac, pulmonary or omolateral lower limb alteration was observed. Endovascular exclusion of the arterio-venous fistula and pseudoaneurysm was performed, which included pseudoaneurysm embolization.

Endovascular treatment options for complex abdominal aortic aneurysms.

Purpose: To report short-term and midterm outcomes of endovascular aneurysm repair (EVAR) of complex aneurysms requiring revascularization of visceral arteries.

Materials And Methods: Prospective data were collected from patients deemed unsuitable for conventional EVAR and conventional surgery who were treated with different endovascular approaches according to the clinical presentation of the aneurysm. Custom-made fenestrated endovascular aneurysm repair (CM f-EVAR) was used in the elective setting, homemade fenestrated endovascular aneurysm repair (HM f-EVAR) or HM f-EVAR combined with chimney endovascular aneurysm repair (ch-EVAR) was used in the emergent setting in patients with hemodynamic stability, and ch-EVAR was used in unstable cases.

Aortic arch and descending thoracic aortic saccular aneurysms treatment with fenestrated endograft and chimney technique for aortic branch rescue.

We report the case of a 76-year-old man presented with three saccular aneurysms at the aortic arch and descending thoracic aorta. A two-staged hybrid approach was performed. A left common carotid-to-left subclavian artery bypass and a custom-made fenestrated endograft were used for the two proximal aneurysms.

Ruptured thoracoabdominal aneurysm treatment with modified chimney stent graft.

A 76-year-old woman presented with symptomatic contained-ruptured thoracoabdominal aneurysm at the level of the superior mesenteric artery (SMA) and the hepatic artery origin from the SMA. The chimney technique for celiac trunk, SMA, and right renal artery (periscope configuration) was performed. An endovascular leak from the distal landing zone of the SMA stent graft was treated using a second modified stent graft with the SMA branches preservation.

Hybrid treatment of symptomatic chronic isolated carotid bifurcation.

Total chronic occlusion of the common carotid artery with patent internal and external carotid arteries can induce cerebral embolism and hypoperfusion. We report a hybrid approach that was used to treat 2 patients presented with symptomatic chronic occlusion of the common carotid artery and ipsilateral internal carotid stenosis. Antegrade recanalization and retrograde stenting of the common carotid artery was performed in both patients associated to carotid bulb endarterectomy.

Endovascular management of total juxtarenal aortic occlusive disease in high-risk patients: technical considerations and clinical outcome.

Background: To report our single-center experience in the endovascular treatment of juxtarenal aorto-iliac occlusions.

Methods: Between December 2008 and December 2012, 13 patients with total juxtarenal aorto-iliac occlusion, considered at high risk for open revascularization, were treated by endovascular means at our Department. Inclusion criteria were severe intermittent claudication, rest pain and distal tissue loss.

Chimney technique for aortic arch pathologies: an 11-year single-center experience.

Purpose: To report our single-center experience with the chimney technique for aortic arch pathologies and the mid- to long-term results in these patients.

Methods: From June 2002 to May 2013, 26 patients (18 men; mean age 71.2 years, 53-86) underwent thoracic endovascular aortic repair (TEVAR) combined with chimney technique.

From aortouniiliac bifurcated to aortobisiliac trifurcated endograft for hypogastric artery preservation during EVAR.

An 81-year-old man presented with rapid enlargement of a 2-year known abdominal aortic and common iliac aneurysms. A hybrid approach to preserve both hypogastric arteries (HAs) was planned: a bifurcated endograft for the right aortoiliac axis, right femoral-to-left femoral artery bypass, and left external-to-internal iliac artery stent graft placement. Urethral stenosis requiring an epicystostomy rendered this approach not feasible.

Re-TEVAR for complications after blunt aortic traumatic injury stenting.

We report an endovascular approach that was used to treat two patients with previous thoracic aortic repair or endovascular repair (TEVAR) for blunt thoracic aortic injury. The first patient was a 38-year-old man who presented with distal intragraft thrombosis 24 months after TEVAR. The second patient, a 32-year-old man, developed a symptomatic distal device collapse at 39th month follow-up, associated with buttock claudication.