title: Treatment of a juxtarenal aneurysm with the Nellix endovascular aneurysm sealing system and chimney stent.
abstract: OBJECTIVE
  To present treatment of a juxtarenal aneurysm using the Nellix endovascular aneurysm sealing system (EVAS) and a chimney stent.
  
  
  METHODS
  A 79-year-old woman was diagnosed with a 6-cm juxtarenal aneurysm. Standard endovascular aneurysm repair was not possible due to lack of an adequate infrarenal landing zone, and poor iliac access and angulated visceral aortic branches precluded a custom-made fenestrated solution. The patient was not a suitable candidate for open surgery due to significant comorbidity, so she underwent successful endovascular aneurysm repair with the Nellix EVAS system and a renal chimney stent. Follow-up imaging at 6 months showed a sealed aneurysm sac and patent renal chimney stent.
  
  
  CONCLUSIONS
  The Nellix EVAS system obliterates the aneurysm sac using polymer-filled endobags. The ability of the endobags to conform to adjacent structures may offer advantages over conventional endografts when combined with parallel grafts designed to treat juxtarenal aneurysms.
authors.affiliation: St George's Vascular Institute, St George's Healthcare NHS Trust, London, UK.
authors.forename: Amir H
authors.initials: AH
authors.lastname: Malkawi
authors.forename: Jorg L
authors.initials: JL
authors.lastname: de Bruin
authors.forename: Ian M
authors.initials: IM
authors.lastname: Loftus
authors.forename: Matt M
authors.initials: MM
authors.lastname: Thompson
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D011474:Prosthesis Design; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: abdominal aortic aneurysm; balloon-expandable stent; chimney graft; endovascular aneurysm repair; juxtarenal aneurysm; renal artery; stent-graft