Search results for "chimney graft"

showing 10 items of 11 documents

Classification of Chimney EVAR-Related Endoleaks: Insights from the PERICLES Registry

2017

Juxtarenal aortic aneurysms (JAAs) pose significant challenges for endovascular aneurysm repair (EVAR). A short or absent infrarenal neck typically excludes standard EVAR as a viable or reasonable treatment option. In this context, the use of chimney grafts (chEVAR) is gaining in popularity and applicability. These grafts are designed to course in the aortic lumen outside the main stent-graft to maintain normal perfusion to the involved target branches. As such, they may represent a promising and less resource-intensive option for management of JAAs. However, this technical strategy is not without challenges of its own, particularly the inevitable creation of “gutters” that result from the …

medicine.medical_specialtyRadiology Nuclear Medicine and Imagingabdominal aortic aneurysm; chimney graft; chimney technique; endograft; endoleak; stent-graftendoleak610 Medicine & health030204 cardiovascular system & hematologySettore MED/22 - Chirurgia Vascolare2705 Cardiology and Cardiovascular Medicine03 medical and health sciences0302 clinical medicineabdominal aortic aneurysmchimney techniqueNuclear Medicine and Imagingmedicine2741 Radiology Nuclear Medicine and ImagingChimney030212 general & internal medicinestent-graftbusiness.industryChimney graftchimney graftendograftmedicine.diseaseAbdominal aortic aneurysmSurgery10020 Clinic for Cardiac Surgery2746 SurgerygraftSurgerystentRadiologybusinessCardiology and Cardiovascular Medicineabdominal aortic aneurysm; chimney graft; chimney technique; endograft; endoleak; stent-graft; Radiology Nuclear Medicine and Imaging; Cardiology and Cardiovascular Medicine
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A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks.

2015

Purpose: To evaluate the midterm outcomes of chimney and/or periscope grafts (CPGs) in patients presenting type I endoleak after a previous endovascular aneurysm repair (EVAR). Methods: Between June 2002 and April 2014, 24 consecutive patients (mean age 73.9±9.2 years; 23 men) presenting a type I endoleak were addressed with CPGs to extend the proximal and/or distal landing zone and to maintain side branch perfusion. Indication for treatment was a type Ia endoleak in 23 (96%) patients and a type Ib endoleak in one. Median interval from the previous EVAR to endoleak treatment with CPGs was 52.2±48.9 months (range 0.2–179). All patients had proximal/distal landing zones precluding any standa…

Malemedicine.medical_specialtyEndoleakmedicine.medical_treatmentparallel graftTarget vesselmorbidityperiscope graftEndovascular aneurysm repairpararenal aortic aneurysmSettore MED/22 - Chirurgia Vascolarelaw.inventionendovascular aneurysm repairBlood Vessel Prosthesis Implantationabdominal aortic aneurysmlawRecurrencethoracoabdominal aortic aneurysmMedicineHumansRadiology Nuclear Medicine and imagingIn patientChimneyself-expanding covered stentVascular PatencyAgedabdominal aortic aneurysm; chimney graft; endoleak; endovascular aneurysm repair; morbidity; mortality; parallel graft; pararenal aortic aneurysm; patency; periscope graft; reintervention; self-expanding covered stent; stent-graft; target vessel; thoracoabdominal aortic aneurysmreinterventionstent-graftbusiness.industryEndovascular ProceduresChimney graftchimney graftmedicine.diseasemortalityAbdominal aortic aneurysmSurgeryBlood Vessel ProsthesisSurvival RateTreatment OutcomeSurgeryFemalePeriscopeCardiology and Cardiovascular Medicinebusinesspatencytarget vesselAortic Aneurysm AbdominalJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
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Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies

2020

Background: The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry. Methods: Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed. Results: Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elect…

MaleTime Factorsmedicine.medical_treatmentTechnical success030204 cardiovascular system & hematologyEndovascular aneurysm repairSettore MED/22 - Chirurgia VascolarePostoperative ComplicationsRenal Artery0302 clinical medicineRisk FactorsSuperior mesenteric arteryChimneyRegistries030212 general & internal medicineSuperior mesenteric arteryAged 80 and overTriple chimney EVARIncidence (epidemiology)Endovascular ProceduresChimney graftEuropeSuprarenal aneurysmsTreatment OutcomeCohortFemaleStentsCardiology and Cardiovascular Medicinemedicine.medical_specialtyAortic DiseasesProsthesis DesignBlood Vessel Prosthesis Implantation03 medical and health sciencesAneurysmMesenteric Artery Superiormedicine.arterymedicineHumansComplex aneurysmAgedRetrospective StudiesSuprarenal aneurysmbusiness.industryComplex aneurysms; Multiple chimney EVAR; Superior mesenteric artery; Suprarenal aneurysms; Triple chimney EVARmedicine.diseaseMultiple chimney EVARUnited StatesBlood Vessel ProsthesisSurgerySurgerybusinessComplex aneurysms
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CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies

2013

PURPOSE: To present the 24-month radiological follow-up data for patients with pararenal aortic pathologies treated with chimney and periscope grafts during endovascular repair. METHODS: Between January 2008 and December 2011, 124 high-risk patients with complex pararenal aortic pathologies were treated using the chimney technique at 2 European vascular and cardiovascular centers with advanced experience of the described technique. In particular, 50 patients were treated at Site 1 and 74 at Site 2. Forty (32.2%) patients (32 men; mean age 79.2±4.9 years) completed computed tomographic angiography follow-up at 24 months postoperatively. RESULTS: The overall technical success was 100%, and th…

Malemedicine.medical_specialtyTime Factorsmedicine.medical_treatmentAortic Diseases610 Medicine & healthEndovascular aneurysm repair2705 Cardiology and Cardiovascular MedicineAortic aneurysmAneurysmmedicine.arterymedicineHumans2741 Radiology Nuclear Medicine and ImagingRadiology Nuclear Medicine and imagingAorta AbdominalEmbolizationSuperior mesenteric arteryAgedendovascular aneurysm repair chimney graft periscope graft pararenal aortic pathologies aortic aneurysm para-anastomotic aneurysm ruptured aneurysm stent-graft balloon-expandable stent-graft computed tomographic angiography endoleak renal arteries superior mesenteric artery sac shrinkage sac expansionmedicine.diagnostic_test10042 Clinic for Diagnostic and Interventional Radiologybusiness.industryEndovascular ProceduresAngiographyPerioperativemedicine.diseaseBlood Vessel Prosthesis10020 Clinic for Cardiac Surgery2746 SurgerySurgeryCuffAngiographyFemaleStentsSurgeryRadiologyTomography X-Ray ComputedCardiology and Cardiovascular MedicinebusinessFollow-Up StudiesJournal of Endovascular Therapy
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Chimney and Periscope Grafts Observed Over 2 Years After Their Use to Revascularize 169 Renovisceral Branches in 77 Patients With Complex Aortic Aneu…

2013

Purpose: To evaluate the performance of periscope and/or chimney grafts (CPGs) in the endovascular treatment of pararenal or thoracoabdominal aneurysms using off-the-shelf devices. Methods: Between February 2002 and August 2012, 77 consecutive patients (62 men; mean age 7369 years) suffering from pararenal aortic (n¼55), thoracoabdominal (n¼16), or arch to visceral artery aneurysms (n¼6) were treated with aortic stent-graft implantation requiring chimney and/or periscope grafts to maintain side branch perfusion. CPGs were planned in advance and were not used as bailout. A standardized follow-up protocol including computed tomographic angiography, laboratory testing, and clinical examination…

aortic aneurysm pararenal aortic aneurysm thoracoabdominal aortic aneurysm aortic arch endovascular aneurysm repair renal artery superficial mesenteric artery celiac trunk target vessel stent-graft side branch chimney graft periscope graft parallel graft target vessel patency endoleak side branch occlusionSettore MED/22 - Chirurgia Vascolare
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Chimney and periscope grafts to facilitate endovascular treatment of aortic transection in a patient with aberrant right subclavian artery

2014

Purpose: To report the use of parallel grafts to extend the proximal landing zone for stentgraft repair of aortic transection involving an aberrant right subclavian artery (ARSA). Case Report: A 28-year-old patient was referred for treatment of traumatic aortic transection with contained rupture at the level of an ARSA. Immediate thoracic endovascular aortic repair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealing and maintain perfusion to both subclavian arteries, a chimney stent to the left subclavian artery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. After surgical repair of all fractures, the patient was discharged 1 month aft…

Adultmedicine.medical_specialtyTime FactorsAortic RuptureCardiovascular AbnormalitiesSubclavian ArteryHemodynamics610 Medicine & healthProsthesis DesignAortographySettore MED/22 - Chirurgia Vascolare2705 Cardiology and Cardiovascular MedicineBlood Vessel Prosthesis ImplantationBlood vessel prosthesisX ray computedmedicine.arterymedicineHumansThoracic aorta2741 Radiology Nuclear Medicine and ImagingRadiology Nuclear Medicine and imagingcardiovascular diseasesEndovascular treatmentAortabusiness.industryEndovascular ProceduresHemodynamicsAberrant right subclavian arteryVascular System InjuriesAneurysmBlood Vessel ProsthesisSurgery10020 Clinic for Cardiac Surgery2746 SurgeryTreatment Outcomesurgical procedures operativeRegional Blood FlowLanding zonecardiovascular systemStentsSurgeryAneurysm surgeryRadiologyDeglutition DisordersTomography X-Ray ComputedCardiology and Cardiovascular Medicinebusinessthoracic aorta aortic transection trauma thoracic endovascular aortic repair aberrant right subclavian artery left subclavian artery stent-graft parallel graft chimney graft periscope graft landing zone
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Mid-term Results of Chimney and Periscope Grafts in Supra-aortic Branches in High Risk Patients

2017

Purpose Report mid-term outcomes of thoracic endovascular aneurysm repair (TEVAR) with chimney and periscope grafts (CPG) in supra-aortic branches (SAB). Methods Retrospective analysis, from October 2009 to May 2014, of patients with aneurysms requiring TEVAR with zone 0/1/2 proximal landing in association with at least one CPG in the SAB. All patients were considered at high risk for conventional surgery. Peri-operative mortality and morbidity, retrograde type A dissection, maximum aortic transverse diameter (TD) and its post-operative evolution, endoleak, survival, freedom from cardiovascular re-interventions, and CPG freedom from occlusion during the follow-up were analysed. Results Fort…

MaleTime FactorsEndoleakComputed Tomography Angiographymedicine.medical_treatmentMid term resultsKaplan-Meier Estimate030204 cardiovascular system & hematologySettore MED/22 - Chirurgia VascolareEndovascular aneurysm repairAortic aneurysmPostoperative Complications0302 clinical medicineRisk FactorsOcclusionMedicine030212 general & internal medicineAortic arch aneurysm; Chimney graft/technique; Endoleak; Endovascular aneurysm repair; Parallel graft; Periscope graft; Surgery; Cardiology and Cardiovascular MedicineAged 80 and overeducation.field_of_studyHigh risk patients10042 Clinic for Diagnostic and Interventional RadiologyEndovascular ProceduresMiddle Aged2746 SurgeryTreatment Outcomecardiovascular systemFemaleRadiologyCardiology and Cardiovascular MedicineAdultmedicine.medical_specialtyPopulation610 Medicine & healthProsthesis DesignAortographyRisk AssessmentDisease-Free Survival2705 Cardiology and Cardiovascular MedicineBlood Vessel Prosthesis ImplantationEndovascular aneurysm repair03 medical and health sciencesAneurysmmedicine.arteryHumanseducationAgedRetrospective StudiesAortaAortic Aneurysm ThoracicParallel graftAortic arch aneurysmbusiness.industryPatient SelectionChimney graft/techniquemedicine.diseaseBlood Vessel Prosthesis10020 Clinic for Cardiac SurgerySurgeryPeriscope graftSurgerybusinessEuropean Journal of Vascular and Endovascular Surgery
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Multiple periscope and chimney grafts to treat ruptured thoracoabdominal and pararenal aortic aneurysms

2011

Purpose: To report midterm outcomes after urgent endovascular repair of ruptured pararenal or thoracoabdominal aortic aneurysms using multiple periscope and chimney grafts to preserve renovisceral branch perfusion and facilitate aneurysm exclusion. Methods: Nine consecutive men (mean age 72614 years, range 40–88) presenting with ruptured thoracoabdominal (n56), pararenal (n52), or infrarenal (n51) aortic aneurysm underwent urgent endovascular repair with at least 1 periscope graft delivered via a transfemoral access; chimney grafts were installed from an axillary access. In all, 17 periscope and 7 chimney grafts were used to reperfuse 11 renal and 13 visceral arteries in the 9 patients. The…

AdultMalemedicine.medical_specialtyTime Factorsmedicine.medical_treatmentAortic RuptureLess invasive610 Medicine & healthRuptured Aortic AneurysmProsthesis DesignEndovascular aneurysm repairSettore MED/22 - Chirurgia VascolareAortography2705 Cardiology and Cardiovascular Medicinelaw.inventionBlood Vessel Prosthesis ImplantationlawmedicineHumans2741 Radiology Nuclear Medicine and ImagingRadiology Nuclear Medicine and imagingChimneyAgedRetrospective Studiesendodebranching renovisceral arteries chimney graft periscope graft stentgraft endograft ruptured aortic aneurysm ruptured thoracoabdominal aortic aneurysm ruptured pararenal aortic aneurysm ruptured AAA endovascular aneurysm repairAged 80 and overAortic Aneurysm Thoracicbusiness.industry10042 Clinic for Diagnostic and Interventional RadiologyEndovascular ProceduresChimney graftBlood flowMiddle AgedSurgeryBlood Vessel Prosthesis10020 Clinic for Cardiac Surgery2746 SurgeryTreatment Outcomecardiovascular systemSurgeryFemaleStentsRadiologyPeriscopeCardiology and Cardiovascular MedicinebusinessTomography X-Ray ComputedAortic Aneurysm Abdominal
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Chimney endografting for pararenal aortic pathologies using transfemoral access and the lift technique

2013

Purpose: To present a technique for transfemoral implantation of parallel grafts into the renal arteries in patients with anatomy or morphology that blocks standard antegrade chimney graft delivery. Technique: In a totally percutaneous approach, a 5-F pigtail angiographic catheter is passed into the aorta above the renal arteries via a 0.035-inch hydrophilic guidewire, followed by an 8-F sheath. The target vessel is cannulated with the hydrophilic wire followed by a 5-F reverse curve catheter; the wire is changed for a Rosen wire. The main stent-graft body is delivered and parked at the level of the aortic bifurcation. The Viabahn chimney endograft is advanced ~1 to 2 cm into the target ren…

Settore MED/22 - Chirurgia Vascolareendovascular repair abdominal aorta pararenal aorta aneurysm endovascular aneurysm repair stent-graft chimney graft chimney technique deployment technique self-expanding stent-graft
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Mid-Term Results of Endovascular Aneurysm Sealing in the Treatment of Abdominal Aortic Aneurysm With Unfavorable Morphology.

2020

Purpose: To report mid-term results of endovascular aneurysm sealing (EVAS) of abdominal aortic aneurysms (AAA) deemed unsuitable for a standard endovascular aneurysm repair (EVAR). Methods: A prospectively maintained database of 42 patients with EVAR-unfavorable anatomy treated by EVAS combined with chimney grafts in case of the proximal AAA neck shorter than 5 mm was analyzed. Early outcomes included final angiographic result, intra- and early post-operative deaths, and complications. Mid-term outcomes included all-cause mortality (ACM), aneurysm-related mortality (ARM), patency of the stents, occurrence of endoleaks, serious complications and graft failures defined as the AAA growth of m…

Malemedicine.medical_specialtyTime FactorsDatabases Factualmedicine.medical_treatmentMid term results030204 cardiovascular system & hematologyEndovascular aneurysm repairRisk AssessmentNellix device03 medical and health sciencesBlood Vessel Prosthesis Implantationabdominal aortic aneurysm0302 clinical medicineAneurysmPostoperative ComplicationsRisk Factorschimney graftsmedicineHumans030212 general & internal medicineVascular PatencyAgedendovascular aneurysm sealingbusiness.industryEndovascular ProceduresGeneral MedicineMiddle Agedmedicine.diseaseAbdominal aortic aneurysmSurgeryBlood Vessel ProsthesisProsthesis FailureTreatment OutcomeSurgeryFemaleStentsCardiology and Cardiovascular Medicinebusinessoutside IFUAortic Aneurysm AbdominalVascular and endovascular surgery
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