Search results for "chimney technique"

Aneurismas complejos de la aorta abdominal: cirugía abierta frente a exclusión endovascular avanzada. Estudio comparativo.

2015

Justificación del estudio e hipótesis de trabajo: la enfermedad aneurismática de la aorta se estima que afecta al 2%-7% de los varones mayores de 60 años. Dichas estimaciones, extrapoladas a la población de España, se corresponderían con 140.000-350.000 personas portadoras de una aneurisma de aorta abdominal. En siete de cada cien personas acaece la rotura del aneurisma, siendo actualmente la décima causa de muerte en varones mayores de 55 años. En aquellos pacientes de alto riesgo para la cirugía abierta en los que la exclusión endovascular con endoprótesis de sellado infrarrenal está contraindicada por mala calidad del cuello aneurismático, la exclusión endovascular avanzada con endopróte…

Rationale for VORTEC and Chimney techniques

2011

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 …

Incidence and prognostic factors related to major adverse cerebrovascular events in patients with complex aortic diseases treated by the chimney tech…

2018

Abstract Objective Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. Methods The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatme…

Current role of the chimney technique in the treatment of complex abdominal aortic pathologies: A position paper from the PERICLES Registry investiga…

2020

Historically, chimney/snorkel endovascular aortic repair (Ch-EVAR) emerged as a rescue technique to revascularize and/or preserve inadvertently covered critical branch vessels during infrarenal aortic endografting. Next, in its evolutionary path, Ch-EVAR offered a viable treatment option for complex aortic repair, and particularly in situations where fenestrated/ branched EVAR was not a therapeutic option due to the lack of availability and/or anatomical constraints. In this context, this technique offered distinct advantages such as off-the-shelf availability, straightforward implantation techniques, and lower resource use-intensity enabling performance by a large number of operators manag…

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…

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

2018

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%). O…