Chimney technique in combination with a sac-anchoring endograft for juxtarenal aortic aneurysms: technical aspects and early results.
| Autor: | Dinkelman MK; Department of Vascular Surgery, Elisabeth TweeSteden Hospital, Tilburg, The Netherlands - s.overeem@antoniusziekenhuis.nl., Overeem SP, Bockler D, DE Vries JP, Heyligers JM |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of cardiovascular surgery [J Cardiovasc Surg (Torino)] 2016 Oct; Vol. 57 (5), pp. 730-6. Date of Electronic Publication: 2016 May 13. |
| Abstrakt: | Background: Juxtarenal aortic aneurysms (JAAs) pose clinical challenges for vascular specialists. Chimney endovascular sealing (Ch-EVAS) might be an ideal endovascular solution in the treatment of JAAs. We present technical aspects and early clinical results of a multicenter experience with Ch-EVAS. Methods: This was a retrospective, multicenter study. Between November 2014 and March 2016, 16 patients underwent elective endovascular repair of JAAs with Ch-EVAS of 1 or 2 renal and/or superior mesenteric artery vessels. Essential technical steps, early complications, chimney stent patency, gutter formation, type IA endoleak, 30-day outcome, renal function, and neck characteristics were the endpoints. Results: There were 26 chimney stents implanted with 100% technical success. The intraoperative death and 30 day mortality was 0%. Secondary interventions were required in 3 patients each due to type IA endoleak, limb occlusion and brachial dissection. The latter patient presented with renal chimney stent occlusion and required hemodialysis. One patient was known to have a pulmonary malignancy and left-sided carotid stenosis and sustained a left hemispheric stroke after the endovascular procedure. The preoperative median aortic neck length was 3 mm, after Ch-EVAS the median seal length between endobags and the aortic neck was 25 mm. No further significant changes in neck morphology were found at the one-month follow-up. Conclusions: Ch-EVAS is an off-the-shelf solution to treat JAAs with high technical success. Longer-term follow-up with a substantial number of patients can answer the question of whether Ch-EVAS is a sustainable technique that is preferred over open surgery or fenestrated endovascular aneurysm repair. |
| Databáze: | MEDLINE |
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