Alexander Massmann1, Ferdinand Serracino-Inglott, Arno Buecker. 1. Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Kirrberger Straße, 66421, Homburg, Germany, alexander.massmann@uks.eu.
Abstract
PURPOSE: To report the first experience using the chimney technique in combination with the latest-generation low-profile stent-graft to seal abdominal aortic aneurysms having a very short neck (proximal sealing zone) and difficult access due to very small iliac vessels. MATERIALS AND METHODS: Use of an ultra low-profile 14F delivery aortic stent-graft system (Ovation; Trivascular, Santa Rosa, CA) with chimneys to the lowermost renal arteries in two patients who were not anatomically suitable for endovascular aortic aneurysm repair (EVAR) and too frail for open surgery. RESULTS: Implantation of stent-grafts and chimneys was technically successful without endoleak or other postinterventional complications. Follow-up after >1 year confirmed complete aneurysm exclusion, shrinkage of the aneurysm sac, and patent renal perfusion by way of the chimney. CONCLUSION: Ultra low-profile aortic stent-graft systems are particularly helpful in case of inadequate small iliac access vessels and allow EVAR for short-necked aortic aneurysms if technical contraindications obviate FEVAR and physical impairment discourages open surgical repair.
PURPOSE: To report the first experience using the chimney technique in combination with the latest-generation low-profile stent-graft to seal abdominal aortic aneurysms having a very short neck (proximal sealing zone) and difficult access due to very small iliac vessels. MATERIALS AND METHODS: Use of an ultra low-profile 14F delivery aortic stent-graft system (Ovation; Trivascular, Santa Rosa, CA) with chimneys to the lowermost renal arteries in two patients who were not anatomically suitable for endovascular aortic aneurysm repair (EVAR) and too frail for open surgery. RESULTS: Implantation of stent-grafts and chimneys was technically successful without endoleak or other postinterventional complications. Follow-up after >1 year confirmed complete aneurysm exclusion, shrinkage of the aneurysm sac, and patent renal perfusion by way of the chimney. CONCLUSION: Ultra low-profile aortic stent-graft systems are particularly helpful in case of inadequate small iliac access vessels and allow EVAR for short-necked aortic aneurysms if technical contraindications obviate FEVAR and physical impairment discourages open surgical repair.
Authors: Alexander Massmann; Peter Fries; Roushanak Shayesteh-Kheslat; Arno Buecker; Michael Stöckle; Christina Niklas Journal: J Vasc Surg Cases Innov Tech Date: 2020-04-14