Background: Conventional graft replacement for a juxtarenal abdominal aortic aneurysm (JRAAA) remains challenging for high-risk patients since it often requires the reconstruction of some visceral arteries.
Case Presentation: A 76-year-old woman was diagnosed with an 87 × 48 mm saccular JRAAA. Open graft replacement was contraindicated because of frailty and a past history of trans-thoracoabdominal esophagectomy. Chimney endovascular aortic repair (ChEVAR) with three chimney endografts was successfully performed without any endoleaks, and each visceral circulation was kept intact. The patient was discharged uneventfully on postoperative day 8. Significant shrinkage of the aneurysmal sac and preservation of flow through each chimney graft were observed on computed tomography 6 months postoperatively, with no significant increase in serum creatinine levels on laboratory testing.
Conclusions: ChEVAR can be a useful surgical option instead of conventional operations, especially for high-risk cases.
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http://dx.doi.org/10.1186/s13019-024-02784-x | DOI Listing |
EJVES Vasc Forum
November 2024
Vascular Surgery, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Objective: Paravisceral aortic lesions present significant challenges for endovascular treatment. This retrospective analysis of consecutively treated patients from April 2017 to June 2021 aimed to analyse the outcome of primary intra-operative embolisation of aortic complicated pseudoaneurysms and gutter channels during parallel graft (PG) repair of paravisceral symptomatic aortic pseudoaneurysms.
Methods: Patients with symptomatic pseudoaneurysms of the paravisceral aorta treated with PGs using chimney or periscope configurations were included.
J Vasc Surg
January 2025
Divisions of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address:
Objectives: Endovascular aneurysm repair (EVAR) for large infrarenal abdominal aortic aneurysms (AAA) has been associated with worse outcomes compared to EVAR for smaller AAAs. Whether these findings apply to complex AAAs (cAAA) remains uncertain.
Methods: We identified all intact complex EVAR (cEVAR) from 2012-2024 in the Vascular Quality Initiative.
J Cardiothorac Surg
January 2025
Department of Vascular Surgery, Zhangzhou Affiliated Hospital of FuJian Medical University, Zhangzhou, Fujian Province, 363000, China.
Background: Thoracic aortic endovascular repair (TEVAR) is the most commonly employed method for treating type B aortic dissection (TBAD). One of the primary challenges in TEVAR is the reconstruction of the left subclavian artery (LSA). Various revascularization strategies have been utilized, including branch stent techniques, fenestration techniques, chimney techniques, and hybrid techniques.
View Article and Find Full Text PDFJ Clin Med
January 2025
Department of Vascular Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
: The parallel stent graft endovascular aortic repair (PGEVAR) technique is an off-the-shelf option used for elective complex abdominal aortic aneurysm repair with acceptable outcome results, as reported so far. The PGEVAR technique, using chimney or periscope parallel grafts, can also be used for patients with ruptured complex abdominal aortic aneurysms. However, only few data about the mid- to long-term outcomes are available.
View Article and Find Full Text PDFMed Eng Phys
December 2024
Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Introduction: Abdominal aortic aneurysms present a significant clinical challenge, particularly when located near the renal arteries. In cases of infra-renal abdominal aortic aneurysms, the main stent graft may occlude the renal arteries, disrupting blood supply. To prevent this, two 'chimney' stent grafts can be implanted to maintain renal artery perfusion.
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