title: Is the chimney graft technique a safe and feasible approach to treat urgent aneurysm and pseudoaneurysm of the abdominal aorta? An analysis of our experience and technical considerations.
abstract: The chimney graft (CG) technique, based on the deployment of a covered stent parallel to the aortic endograft, has been proposed to achieve a safe proximal fixation extending the sealing zone. We report our experience with the CG technique in an emergency setting. Between December 2010 and April 2012, 4 patients underwent the CG technique. The mean age was 79 (range 76-82 years) and 3 patients were men. The median aneurysm diameter was 64.7 mm (range 63-68 mm). Indications for CG were painful proximal para-anastomotic aneurysm in 2 cases and symptomatic juxtarenal aneurysm in the other 2. Target vessels were both the renal arteries. Technical success was achieved in 100% and no intraoperative complications occurred. No stent-related complications, or Type I endoleak, were detected. No death occurred during the postoperative course. Creatinine elevation was observed in 2 cases. At follow-up, no endoleaks or rupture occurred. One patient died of myocardial infarction 3 months after the procedure. The primary patency rate of covered stents was 100%. The CG technique seems to be safe and feasible with an excellent patency rate of covered stents and a low incidence of endoleaks. More evidence in the literature is needed to carry out a validation of this technique in an emergency.
authors: Unit of Vascular and Endovascular Surgery, San Paolo Hospital, Civitavecchia, Rome, Italy. lucamaria.siani@tin.it
authors: Andrea
authors: A
authors: Siani
authors: Federico
authors: F
authors: Accrocca
authors: Roberto
authors: R
authors: Gabrielli
authors: Giustino
authors: G
authors: Marcucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004630:Emergencies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012384:Rome; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome