title: Novel chimney-graft technique for preserving hypogastric flow in complex aortoiliac aneurysms.
abstract: We describe the feasibility and result of a novel approach to preserve pelvic perfusion during endovascular aortoiliac aneurysm repair (EVAR) in patients with aortoiliac aneurysms extending to the iliac bifurcation. The iliac chimney-graft technique consists of the deployment of a ViaBahn™ graft into the hypogastric artery in combination with standard abdominal aortic stent-grafts. The chimney graft was deployed using a transsubclavian access and placed parallel with the iliac limb into the standard aortic stent graft, which was deployed directly before. The technical procedure was successful. Postoperative control showed a sufficiently excluded aneurysm without evidence of endoleak and good distal perfusion of both iliac arteries. The CT-scan after 6 months confirmed the result. The chimney-graft stent grafts to maintain perfusion to hypogastric arteries are feasible and provide an alternative to hypogastric artery exclusion or branched grafts. Long-term follow-up is needed to evaluate stent-graft patency and failure rates.
authors.affiliation: Department of Vascular Surgery, Niels-Stensen-Hospital, Osnabrueck, Germany. joerg.heckenkamp@mho.de
authors.forename: J
authors.initials: J
authors.lastname: Heckenkamp
authors.forename: J
authors.initials: J
authors.lastname: Brunkwall
authors.forename: T
authors.initials: T
authors.lastname: Luebke
authors.forename: M
authors.initials: M
authors.lastname: Aleksic
authors.forename: F
authors.initials: F
authors.lastname: Schöndube
authors.forename: T
authors.initials: T
authors.lastname: Stojanovic
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D057510:Endovascular Procedures; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011474:Prosthesis Design; D015607:Stents