Sonia Ronchey1, Stefano Fazzini1, Salvatore Scali2, Giovanni Torsello3, Paul Kubilis2, Frank Veith4,5, Konstantinos P Donas3, Felice Pecoraro4,6, Nicola Mangialardi7. 1. 1 Department of Vascular Surgery, San Filippo Neri Hospital, Rome, Italy. 2. 2 Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, USA. 3. 3 Department of Vascular Surgery, St Franziskus Hospital Münster, Germany. 4. 4 Cardiovascular Surgery Unit, University Hospital Zurich, Switzerland. 5. 5 New York University Medical Center, New York, NY, USA. 6. 6 University of Palermo, Vascular Surgery Unit, AOUP "P. Giaccone", Palermo, Italy. 7. 7 Department of Vascular Surgery, "San Camillo-Forlanini" Hospital, Rome, Italy.
Abstract
PURPOSE: The aim of this retrospective analysis was to evaluate the performance of the chimney (ch) technique in the treatment of type Ia endoleaks after standard endovascular aneurysm repair (EVAR). METHODS: Between January 2008 and December 2014, 517 chEVAR procedures were performed in 13 US and European vascular centers (PERICLES registry). Thirty-nine patients (mean age 76.9±7.1 years; 33 men) were treated for persistent type Ia endoleak and had computed tomography angiography or magnetic resonance angiography follow-up at >1 month. Endurant abdominal stent-grafts were used in the 20 cases. Single chimney graft placement was performed in 18 (46%) patients and multiple in 21 (54%). Overall, 70 visceral vessels were targeted for revascularization. RESULTS: Technical success was achieved in 35 (89.7%) cases; 3 persistent type Ia endoleaks and 1 chimney graft occlusion were detected within the first 30 days. Thirty-day mortality was 2.6%. Two other deaths (not aneurysm related) occurred during a mean follow-up of 21.9 months (0.23-71.3). Primary patency of the chimney grafts was 94.3% at 36 months. In a subgroup analysis comparing Endurant to other stent-grafts, no significant differences were observed regarding persistent endoleak [1/20 (5%) vs 2/19 (11%), p=0.6] or reintervention [1/20 (5%) vs 0/19 (0%)]. CONCLUSION: The present series demonstrates that chEVAR in the treatment of post-EVAR type Ia endoleaks has satisfactory results independent of the abdominal and chimney graft combinations. Midterm results show that chEVAR is an effective method for treating type Ia endoleaks.
PURPOSE: The aim of this retrospective analysis was to evaluate the performance of the chimney (ch) technique in the treatment of type Ia endoleaks after standard endovascular aneurysm repair (EVAR). METHODS: Between January 2008 and December 2014, 517 chEVAR procedures were performed in 13 US and European vascular centers (PERICLES registry). Thirty-nine patients (mean age 76.9±7.1 years; 33 men) were treated for persistent type Ia endoleak and had computed tomography angiography or magnetic resonance angiography follow-up at >1 month. Endurant abdominal stent-grafts were used in the 20 cases. Single chimney graft placement was performed in 18 (46%) patients and multiple in 21 (54%). Overall, 70 visceral vessels were targeted for revascularization. RESULTS: Technical success was achieved in 35 (89.7%) cases; 3 persistent type Ia endoleaks and 1 chimney graft occlusion were detected within the first 30 days. Thirty-day mortality was 2.6%. Two other deaths (not aneurysm related) occurred during a mean follow-up of 21.9 months (0.23-71.3). Primary patency of the chimney grafts was 94.3% at 36 months. In a subgroup analysis comparing Endurant to other stent-grafts, no significant differences were observed regarding persistent endoleak [1/20 (5%) vs 2/19 (11%), p=0.6] or reintervention [1/20 (5%) vs 0/19 (0%)]. CONCLUSION: The present series demonstrates that chEVAR in the treatment of post-EVAR type Ia endoleaks has satisfactory results independent of the abdominal and chimney graft combinations. Midterm results show that chEVAR is an effective method for treating type Ia endoleaks.
Authors: Jorn P Meekel; Theodorus G van Schaik; Rutger J Lely; Gerie Groot; Bram B van der Meijs; Willem Wisselink; Jan D Blankensteijn; Kak K Yeung Journal: J Endovasc Ther Date: 2020-04-21 Impact factor: 3.487
Authors: Emanuele Gatta; Gabriele Pagliariccio; Sara Schiavon; Carlo Grilli Cicilioni; Luciano Carbonari Journal: SAGE Open Med Case Rep Date: 2020-09-04