6533b871fe1ef96bd12d1995

RESEARCH PRODUCT

Collected Transatlantic Experience From the PERICLES Registry: Use of Chimney Grafts to Treat Post-EVAR Type Ia Endoleaks Shows Good Midterm Results

Konstantinos P. DonasGiovanni TorselloFelice PecoraroFelice PecoraroPaul KubilisFrank J. VeithSalvatore T. ScaliSonia RoncheyStefano FazziniNicola Mangialardi

subject

MaleTime Factorsabdominal aortic aneurysm; chimney graft; chimney technique; endoleak; endovascular aneurysm repair; juxtarenal aortic aneurysm; parallel graft; pararenal aortic aneurysm; periscope graft; snorkel graftmedicine.medical_treatmentJuxtarenal aortic aneurysm030204 cardiovascular system & hematologySettore MED/22 - Chirurgia VascolareEndovascular aneurysm repairendovascular aneurysm repair0302 clinical medicineRisk FactorsRetrospective analysisChimneyRegistries030212 general & internal medicineAged 80 and overEndovascular ProceduresChimney graftAbdominal aortic aneurysmEuropeTreatment Outcomesnorkel graftFemaleStentsjuxtarenal aortic aneurysmCardiology and Cardiovascular MedicineReoperationmedicine.medical_specialtyparallel graftendoleakperiscope graftProsthesis Designpararenal aortic aneurysmBlood Vessel Prosthesis Implantation03 medical and health sciencesabdominal aortic aneurysmchimney techniquemedicineHumansRadiology Nuclear Medicine and imagingAgedRetrospective Studiesbusiness.industrychimney graftmedicine.diseaseUnited StatesBlood Vessel ProsthesisSurgerySurgerybusinessAortic Aneurysm Abdominal

description

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.

yearjournalcountryeditionlanguage
2018-01-01Journal of Endovascular Therapy
https://doi.org/10.1177/1526602818782941