rome and Aneurysm--False

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.

Topics: Aged; Aged, 80 and over; Aneurysm, False; Aortic Aneurysm, Abdominal; Aortography; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Emergencies; Endovascular Procedures; Female; Humans; Male; Rome; Stents; Tomography, X-Ray Computed; Treatment Outcome