ENDOVASCULAR TREATMENT OF A JUXTARENAL AORTIC ANEURYSM WITH THE CHIMNEY TECHNIQUE
DOI:
https://doi.org/10.48750/acv.58Keywords:
Ch-EVAR, Chimney grafts, Snorkel grafts, EVAR, Juxtarenal aortic aneurysm, complex endovascular repair, Case ReportAbstract
Endovascular treatment of juxtarenal aortic aneurysms is a complex challenge to the vascular surgeon. We present a case of an 83 year old man with a large juxtarenal aneurysm treated with an endovascular approach with chimneys to the left renal artery and superior mesenteric artery. Fenestrated aortic endovascular repair has been considered the preferred endovascular approach in juxtarenal aneurysms, however when the risk of rupture is considered high to wait for a manufactured device and/or when the anatomy is not suitable for a fenestrated repair, chimney endovascular repair is a viable and promptly available option. This case report is an example of the applicability of this treatment with a positive short-term outcome as shown here.
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References
1. Katsargyris A, Topel I, Oikonomou K, et al. Comparison of Outcomes With Open, Fenestrated, and Chimney Graft Repair of Juxtarenal Aneurysms: Are We Ready for a Paradigm Shift? J Endovasc Ther. 2013;20:159–169.
2. Patel R, Katsargyris A, Verhoeven E, et al. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results. Cardiovasc Intervent Radiol. 2013. 36:1443-1451.
3. Verhoeven E.L.G, Katsargyris A, Oikonomou K, et al. Fenestrated Endovascular Aortic Aneurysm Repair as a First Line Treatment Option to Treat Short Necked, Juxtarenal, and Suprarenal Aneurysms. Eur J Vasc Endovasc Surg 2016; 51: 775-781.
4. Greenberg RK, Clair D, Srivastava S, et al. Should patients with challenging anatomy be offered endovascular aneurysm repair? J Vasc Surg 2003; 38: 990-6.
5. Donas KP, Lee JT, Lachat M, et al. Collected World Experience About the Performance of the Snorkel/Chimney Endovascular Technique in the Treatment of Complex Aortic Pathologies, The PERICLES Resgistry. Ann of Surg. 2015; 262 (3): 546-552.
6. Lachat M, Bisdas T, Rancic Z, et al. Chimney Endografting for Pararenal Aortic Pathologies Using Transfemoral Access and the Lift Technique. J Endovasc Ther 2013; 20: 492-497.
7. Kolvenbach, RR. Chimneys Are Smoking Hot: Midterm Resultts of the Chimney Technique in the Repair of Pararenal and Thoracoabdominal Aneurysms. J Endovsc Ther 2013; 20: 606-608.
8. Scali S, Feezor RJ, Chang CK, et al. Critical analysis of results after chimney endovascular aortic aneurysm repair raises cause for concern. J Vasc Surg 2014; 60(4):865-873.
9. Donas K, Pecoraro F, Bisdas T, et al. CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies. J Endovasc Ther 2013; 20:1–6.
2. Patel R, Katsargyris A, Verhoeven E, et al. Endovascular Aortic Aneurysm Repair with Chimney and Snorkel Grafts: Indications, Techniques and Results. Cardiovasc Intervent Radiol. 2013. 36:1443-1451.
3. Verhoeven E.L.G, Katsargyris A, Oikonomou K, et al. Fenestrated Endovascular Aortic Aneurysm Repair as a First Line Treatment Option to Treat Short Necked, Juxtarenal, and Suprarenal Aneurysms. Eur J Vasc Endovasc Surg 2016; 51: 775-781.
4. Greenberg RK, Clair D, Srivastava S, et al. Should patients with challenging anatomy be offered endovascular aneurysm repair? J Vasc Surg 2003; 38: 990-6.
5. Donas KP, Lee JT, Lachat M, et al. Collected World Experience About the Performance of the Snorkel/Chimney Endovascular Technique in the Treatment of Complex Aortic Pathologies, The PERICLES Resgistry. Ann of Surg. 2015; 262 (3): 546-552.
6. Lachat M, Bisdas T, Rancic Z, et al. Chimney Endografting for Pararenal Aortic Pathologies Using Transfemoral Access and the Lift Technique. J Endovasc Ther 2013; 20: 492-497.
7. Kolvenbach, RR. Chimneys Are Smoking Hot: Midterm Resultts of the Chimney Technique in the Repair of Pararenal and Thoracoabdominal Aneurysms. J Endovsc Ther 2013; 20: 606-608.
8. Scali S, Feezor RJ, Chang CK, et al. Critical analysis of results after chimney endovascular aortic aneurysm repair raises cause for concern. J Vasc Surg 2014; 60(4):865-873.
9. Donas K, Pecoraro F, Bisdas T, et al. CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies. J Endovasc Ther 2013; 20:1–6.
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Published
2017-06-03
How to Cite
1.
Gouveia e Melo R, Fernandes e Fernandes R, M. Pedro L, Silvestre L, Queiroz e Sousa G, Garrido P, Fernandes e Fernandes J. ENDOVASCULAR TREATMENT OF A JUXTARENAL AORTIC ANEURYSM WITH THE CHIMNEY TECHNIQUE. Angiol Cir Vasc [Internet]. 2017 Jun. 3 [cited 2024 Apr. 19];13(1):40-4. Available from: https://acvjournal.com/index.php/acv/article/view/58
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Clinical Case
