title: ChEVAS: Combining Suprarenal EVAS with Chimney Technique.
abstract: Endovascular sealing with the Nellix(®) endoprosthesis (EVAS) is a new technique to treat infrarenal abdominal aortic aneurysms. We describe the use of endovascular sealing in conjunction with chimney stents for the renal arteries (chEVAS) in two patients, one with a refractory type Ia endoleak and an expanding aneurysm, and one with a large juxtarenal aneurysm unsuitable for fenestrated endovascular repair (EVAR). Both aneurysms were successfully excluded. Our report confirms the utility of chEVAS in challenging cases, where suprarenal seal is necessary. We suggest that, due to lack of knowledge on its durability, chEVAS should only been considered when more conventional treatment modalities (open repair and fenestrated EVAR) are deemed difficult or unfeasible.
authors.affiliation: Liverpool Vascular & Endovascular Service, Royal Liverpool University Hospital, Liverpool, UK. f.torella@liverpool.ac.uk.|8C Link, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK. f.torella@liverpool.ac.uk.
authors.forename: Francesco
authors.initials: F
authors.lastname: Torella
authors.affiliation: Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK. tze.chan@rlbuht.nhs.uk.
authors.forename: Tze Y
authors.initials: TY
authors.lastname: Chan
authors.affiliation: Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK. usman.shaikh@rlbuht.nhs.uk.
authors.forename: Usman
authors.initials: U
authors.lastname: Shaikh
authors.affiliation: Department of Radiography, University of Salford, Salford, UK. a.england@salford.ac.uk.
authors.forename: Andrew
authors.initials: A
authors.lastname: England
authors.affiliation: Liverpool Vascular & Endovascular Service, Royal Liverpool University Hospital, Liverpool, UK. robert.fisher@rlbuht.nhs.uk.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Fisher
authors.affiliation: Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK. richard.mcwilliams@rlbuht.nhs.uk.
authors.forename: Richard G
authors.initials: RG
authors.lastname: McWilliams
mesh_terms: D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aneurysm; Chimney; EVAR; EVAS; Renal arteries; Type I endoleak