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https://www.readbyqxmd.com/read/29181602/long-parallel-stent-grafts-for-the-treatment-of-complex-aortic-aneurysms
#1
Daniel Silverberg, Uri Rimon, Daniel Raskin, Moshe Halak
PURPOSE: To describe our experience with the chimney technique in endovascular aneurysm repair (ch-EVAR) using long parallel grafts (PGs) of 100 mm or more for the treatment of complex aortic aneurysms. MATERIALS AND METHODS: From 2009 to 2016, data were prospectively collected for patients who underwent ch-EVAR using long PGs. Data included patient demographics and aortic anatomy, technical success, patency and reintervention rate. RESULTS: A total of 29 long PGs were placed in 18 patients (males 16, average age 71 years)...
November 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29103932/incidence-and-prognostic-factors-related-to-major-adverse-cerebrovascular-events-in-patients-with-complex-aortic-diseases-treated-by-the-chimney-technique
#2
Michel J Bosiers, Kenneth Tran, Jason T Lee, Konstantinos P Donas, Frank J Veith, Giovanni Torsello, Felice Pecoraro, Konstantinos Stavroulakis
OBJECTIVE: Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. METHODS: The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatment of complex aortic pathologies...
November 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074111/polar-orientation-of-renal-grafts-within-the-proximal-seal-zone-affects-risk-of-early-type-ia-endoleaks-after-chimney-endovascular-aneurysm-repair
#3
Kenneth Tran, Brant W Ullery, Nathan Itoga, Jason T Lee
OBJECTIVE: The objective of this study was to describe the polar orientation of renal chimney grafts within the proximal seal zone and to determine whether graft orientation is associated with early type Ia endoleak or renal graft compression after chimney endovascular aneurysm repair (ch-EVAR). METHODS: Patients who underwent ch-EVAR with at least one renal chimney graft from 2009 to 2015 were included in this analysis. Centerline three-dimensional reconstructions were used to analyze postoperative computed tomography scans...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259824/endovascular-management-of-proximal-fixation-loss-using-parallel-stent-grafting-techniques-to-preserve-visceral-flow
#4
Adam Tanious, Mathew Wooster, Andrew Jung, Peter R Nelson, Martin R Back, Murray L Shames
BACKGROUND: Proximal fixation loss following endovascular aortic aneurysm repair (EVAR) creates a clinical dilemma. Typically, endovascular salvage requires adequate aortic neck below the renal arteries, in cases with no infrarenal neck proximal extension into the paravisceral aorta using parallel grafts provides an alternative to open graft explant. We present our experience at a tertiary care center with endovascular management of proximal fixation loss following EVAR using parallel stent grafting techniques to preserve renal and visceral branches...
March 1, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27798381/endovascular-aneurysm-sealing-evas-and-chimney-evas-in-the-treatment-of-failed-endovascular-aneurysm-repairs
#5
Marwan Youssef, Sebastian Zerwes, Rudolf Jakob, Oroa Salem, Fritz Dünschede, Christian F Vahl, Bernhard Dorweiler
PURPOSE: To assess the technical success and clinical outcome of reinterventions using the Nellix Endovascular Aneurysm Sealing (EVAS) System to treat complications after endovascular aneurysm repair (EVAR). METHODS: Fifteen consecutive patients (mean age 79 years; 14 men) with prior EVAR were treated with EVAS between March 2014 and December 2015 at 2 institutions. The failed prior EVARs included 13 bifurcated endografts, 1 bifurcated graft plus fenestrated cuff, and 1 tube endograft...
February 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27743807/classification-of-gutter-type-in-parallel-stenting-during-endovascular-aortic-aneurysm-repair
#6
Simon P Overeem, Johannes T Boersen, Richte C L Schuurmann, Erik Groot Jebbink, Cornelis H Slump, Michel M P J Reijnen, Jean-Paul P M de Vries
OBJECTIVE: Gutters can be described as the loss of continuous apposition between the main body of the endograft, the chimney stent graft, and the aortic wall. Gutters have been associated with increased risk of type IA endoleaks and are considered to be the Achilles' heel of chimney endovascular aneurysm repair (ch-EVAR). However, there is no classification yet to classify and quantify gutter types after ch-EVAR. METHODS: Different gutter types can be distinguished by their morphologic appearance in two- and three-dimensional views and reconstructed slices perpendicular to the center lumen line...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27699077/a-case-of-successful-coil-embolization-for-a-late-onset-type-ia-endoleak-after-endovascular-aneurysm-repair-with-the-chimney-technique
#7
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
Juxtarenal aortic aneurysms (JRAAs) are challenging to treat by endovascular aneurysm repair (EVAR) procedures. The chimney technique with EVAR (Ch-EVAR) is one of the feasible and less invasive treatments for JRAAs. However, the main concern of Ch-EVAR is the potential risk of "gutters," which can lead to type Ia endoleak (EL). Most type Ia ELs after Ch-EVAR procedures occurred intraoperatively, and these ELs could be treated using an endovascular technique. However, late-onset type Ia ELs could be extremely rare, which might have a fear of conservative treatment...
2016: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/27433898/regionalization-of-emergent-vascular-surgery-for-patients-with-ruptured-aaa-improves-outcomes
#8
Courtney J Warner, Sean P Roddy, Benjamin B Chang, Paul B Kreienberg, Yaron Sternbach, John B Taggert, Kathleen J Ozsvath, Steven C Stain, R Clement Darling
OBJECTIVE: Safe and efficient endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (r-AAA) requires advanced infrastructure and surgical expertise not available at all US hospitals. The objective was to assess the impact of regionalizing r-AAA care to centers equipped for both open surgical repair (r-OSR) and EVAR (r-EVAR) by vascular surgeons. METHODS: A retrospective review of all patients with r-AAA undergoing open or endovascular repair in a 12-hospital region...
September 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27170147/complementary-role-of-fenestrated-branched-endografting-and-the-chimney-technique-in-the-treatment-of-pararenal-aneurysms-after-open-abdominal-aortic-repair
#9
Andrés Reyes, Konstantinos P Donas, Georgios Pitoulias, Martin Austermann, Claudio Gandarias, Giovanni Torsello
PURPOSE: To evaluate the totally endovascular techniques for treating complex pararenal aortic aneurysms after open repair of abdominal aortic aneurysm. METHODS: This retrospective study involved 34 men (mean age 74 years) with pararenal aortic aneurysms (22 pseudoaneurysms and 12 para-anastomotic aneurysms) that developed a median 11 years (range 4-22) after the primary surgical reconstruction. The median infrarenal neck length was 2 mm (range 0-9). Total endovascular aneurysm repair (EVAR) included the use of fenestrated (f-EVAR; n=17), branched (b-EVAR; n=11), combined f-EVAR/b-EVAR (n=1), and chimney (ch-EVAR; n=4) grafts and the "sandwich" technique (n=1)...
August 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/26961481/the-outcomes-of-endovascular-aneurysm-repair-with-the-chimney-technique-for-juxtarenal-aortic-aneurysms
#10
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
PURPOSE: We collected our experience in the use of chimney technique with endovascular aneurysm repair (Ch-EVAR) for juxtarenal aortic aneurysms (JAAs), and reviewed the outcomes. METHODS: The patients who were treated with Ch-EVAR between January 2012 and December 2015 were retrospectively reviewed. All of the patients underwent endovascular aneurysm repair (EVAR) under general anesthesia. Femoral arterial access was obtained to place the main body of the endograft; brachial or axillary access was obtained to perform the placement of the chimney stent...
June 20, 2016: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26874671/pararenal-aortic-ulcer-repair
#11
COMPARATIVE STUDY
F Taher, A Assadian, J Strassegger, N Duschek, S Koulas, C Senekowitsch, J Falkensammer
OBJECTIVE/BACKGROUND: In order to investigate techniques and outcomes of pararenal penetrating aortic ulcer (PAU) repair, a retrospective cohort study was performed. METHODS: Over the 6 year study period, 12 patients treated for a pararenal PAU were included. Outcome measures included technical success, survival, and peri-operative complications, as well as stent patency. RESULTS: Treatment modalities included hybrid procedures with endovascular aneurysm repair (EVAR) and bypass grafting, chimney EVAR (Ch-EVAR), and fenestrated EVAR (FEVAR)...
April 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/26869488/fenestrated-and-chimney-technique-for-juxtarenal-aortic-aneurysm-a-systematic-review-and-pooled-data-analysis
#12
REVIEW
Yue Li, Zhongzhou Hu, Chujie Bai, Jie Liu, Tao Zhang, Yangyang Ge, Shaoliang Luan, Wei Guo
Juxtarenal aortic aneurysms (JAA) account for approximately 15% of abdominal aortic aneurysms. Fenestrated endovascular aneurysm repair (FEVAR) and chimney endovascular aneurysm repair (CH-EVAR) are both effective methods to treat JAAs, but the comparative effectiveness of these treatment modalities is unclear. We searched the PubMed, Medline, Embase, and Cochrane databases to identify English language articles published between January 2005 and September 2013 on management of JAA with fenestrated and chimney techniques to conduct a systematic review to compare outcomes of patients with juxtarenal aortic aneurysm (JAA) treated with the two techniques...
February 12, 2016: Scientific Reports
https://www.readbyqxmd.com/read/26476671/the-protagoras-study-to-evaluate-the-performance-of-the-endurant-stent-graft-for-patients-with-pararenal-pathologic-processes-treated-by-the-chimney-snorkel-endovascular-technique
#13
MULTICENTER STUDY
Konstantinos P Donas, Giovanni B Torsello, Gianluca Piccoli, Georgios A Pitoulias, Giovanni Federico Torsello, Theodosios Bisdas, Martin Austermann, Daniele Gasparini
OBJECTIVE: The chimney/snorkel endovascular aortic repair (ch-EVAR) is gaining ever-greater acceptance in the treatment of pararenal pathologic processes. However, the published experience includes mainly short-term clinical results with combinations of several abdominal devices and types of chimney grafts. The aim of this study was the midterm evaluation of the Endurant stent graft (Medtronic, Santa Rosa, Calif) as a standard abdominal device for ch-EVAR. METHODS: Between January 2009 and January 2013, prospectively collected data of high-risk patients with pararenal pathologic processes who underwent ch-EVAR with placement of the Endurant abdominal device were analyzed...
January 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26258324/collected-world-experience-about-the-performance-of-the-snorkel-chimney-endovascular-technique-in-the-treatment-of-complex-aortic-pathologies-the-pericles-registry
#14
MULTICENTER STUDY
Konstantinos P Donas, Jason T Lee, Mario Lachat, Giovanni Torsello, Frank J Veith
OBJECTIVES: We sought to analyze the collected worldwide experience with use of snorkel/chimney endovascular aneurysm repair (EVAR) for complex abdominal aneurysm treatment. BACKGROUND: EVAR has largely replaced open surgery worldwide for anatomically suitable aortic aneurysms. Lack of availability of fenestrated and branched devices has encouraged an alternative strategy utilizing parallel or snorkel/chimney grafts (ch-EVAR). METHODS: Clinical and radiographic information was retrospectively reviewed and analyzed on 517 patients treated by ch-EVAR from 2008 from 2014 by prearranged defined and documented protocols...
September 2015: Annals of Surgery
https://www.readbyqxmd.com/read/26142879/complete-endovascular-treatment-of-saccular-aneurysm-of-the-aortic-arch-by%C3%A2-coiling-and-ch-evar
#15
Sebastiaan Martens, Lieven Maene, Roel Beelen
Saccular aneurysm of the aortic arch is a condition with a high associated mortality. Open surgery is often complicated with poor outcome and high postoperative morbidity and mortality. In this case report, we describe an alternative stepwise endovascular repair: coiling of the aneurysm followed by covering of the ostium of the saccular aneurysm by chimney endovascular aortic repair. In our opinion, this technique could be an alternative for a fully customized branched or fenestrated endoprosthesis to treat these kind of aneurysms...
October 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26064770/chimney-graft-as-a-bail-out-procedure-for-endovascular-treatment-of-an-inflammatory-juxtarenal-abdominal-aortic-aneurysm
#16
Francesca Fratesi, Ashok Handa, Raman Uberoi, Ediri Sideso
Inflammatory and juxtarenal Abdominal Aortic Aneurysm (j-iAAA) represents a technical challenge for open repair (OR) due to the peculiar anatomy, extensive perianeurysmal fibrosis, and dense adhesion to the surrounding tissues. A 68-year-old man with an 11 cm asymptomatic j-iAAA was successfully treated with elective EVAR and chimney-graft (ch-EVAR) without postprocedural complications. Target vessel patency and normal renal function are present at 24-month follow-up. The treatment of j-iAAA can be technically challenging...
2015: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/26004962/endovascular-chimney-technique-for-juxtarenal-abdominal-aortic-aneurysm-a-systematic-review-using-pooled-analysis-and-meta-analysis
#17
REVIEW
Yue Li, Tao Zhang, Wei Guo, Chen Duan, Ren Wei, Yangyang Ge, Xin Jia, Xiaoping Liu
BACKGROUND: To evaluate the safety and efficacy of chimney endovascular abdominal aortic repair (Ch-EVAR) for juxtarenal abdominal aortic aneurysm. METHODS: Electronic literature published between 2003 and 2014 were searched from MEDLINE and EMBASE online databases. Inclusion criteria for articles included that more than 3 patients were enrolled, chimney graft techniques were used, and the basic outcomes, such as indications, mortality within 30-day or during follow-up, complications, endoleaks, and branch vessel patency were collected...
August 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25887934/endovascular-treatment-options-for-complex-abdominal-aortic-aneurysms
#18
Sonia Ronchey, Eugenia Serrao, Holta Kasemi, Felice Pecoraro, Stefano Fazzini, Vittorio Alberti, Nicola Mangialardi
PURPOSE: To report short-term and midterm outcomes of endovascular aneurysm repair (EVAR) of complex aneurysms requiring revascularization of visceral arteries. MATERIALS AND METHODS: Prospective data were collected from patients deemed unsuitable for conventional EVAR and conventional surgery who were treated with different endovascular approaches according to the clinical presentation of the aneurysm. Custom-made fenestrated endovascular aneurysm repair (CM f-EVAR) was used in the elective setting, homemade fenestrated endovascular aneurysm repair (HM f-EVAR) or HM f-EVAR combined with chimney endovascular aneurysm repair (ch-EVAR) was used in the emergent setting in patients with hemodynamic stability, and ch-EVAR was used in unstable cases...
June 2015: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/25631457/endovascular-repair-with-chimney-technique-for-juxtarenal-aortic-aneurysm-a-single-center-experience
#19
M XiaoHui, G Wei, H ZhongZhou, L XiaoPing, X Jiang, J Xin
OBJECTIVE: Chimney endovascular aneurysm repair (Ch-EVAR) is a cheap and immediately available method for treatment of juxtarenal aortic aneurysms (JRAAs). The aim of this study was to report experiences and results with balloon expandable stent (BES) for Ch-EVAR. METHODS: From January 2008 to June 2013 (mean time, 26 ± 13 months), 42 patients who underwent Ch-EVAR were retrospectively reviewed. All patients were thought to be at high risk for open surgery and were unsuitable (because of financial issues and fear of delays) for fenestrated endovascular aneurysm repair (FEVAR)...
March 2015: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/23674274/endovascular-aortic-aneurysm-repair-with-chimney-and-snorkel-grafts-indications-techniques-and-results
#20
REVIEW
Rakesh P Patel, Athanasios Katsargyris, Eric L G Verhoeven, Donald J Adam, John A Hardman
The chimney technique in endovascular aortic aneurysm repair (Ch-EVAR) involves placement of a stent or stent-graft parallel to the main aortic stent-graft to extend the proximal or distal sealing zone while maintaining side branch patency. Ch-EVAR can facilitate endovascular repair of juxtarenal and aortic arch pathology using available standard aortic stent-grafts, therefore, eliminating the manufacturing delays required for customised fenestrated and branched stent-grafts. Several case series have demonstrated the feasibility of Ch-EVAR both in acute and elective cases with good early results...
December 2013: Cardiovascular and Interventional Radiology
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