CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies

Felice Pecoraro, Stefan Puchner, Martin Austermann, Giovanni Torsello, Theodosios Bisdas, Felice Pecoraro, Konstantinos P. Donas, Mario Lachat, Zoran Rancic, Thomas Pfammatter, Dieter Mayer

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Purpose: To present the 24-month radiological follow-up data for patients with pararenalaortic pathologies treated with chimney and periscope grafts during endovascular repair.Methods: Between January 2008 and December 2011, 124 high-risk patients with complexpararenal aortic pathologies were treated using the chimney technique at 2 Europeanvascular 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 (32men; mean age 79.264.9 years) completed computed tomographic angiography follow-upat 24 months postoperatively.Results: The overall technical success was 100%, and the early- and midterm procedurerelatedmortality was 0%. Three (2.4%) patients had a perioperative type Ia endoleak thatpersisted; two were treated by transbrachial perigraft embolization and cuff implantation. Thelast patient is under radiological surveillance due to a ‘‘low-flow’’ type Ia endoleak and stablesac size. A type II endoleak was detected in 7 (5.6%) patients. During the 2-year follow-up,significant shrinkage (.5 mm; n¼22) or stable aneurysm diameter (n¼14) was seen in 36 (90%)of the cases. Overall, mean aneurysm sac shrinkage was 12% (p¼0.002) and 10% (p¼0.014) forthe 2 centers, respectively (overall p¼0.008). The causes for sac progression in the 4 (10%)patients were a type Ia endoleak, 2 type II endoleaks, and endotension.Conclusion: The present study demonstrates that the use of chimney and/or periscopeendografts for pararenal aortic pathologies achieves and maintains successful exclusion ofthe aneurysm in 90% of the cases at 24 months of radiological follow-up. In centersexperienced with this approach, the chimney technique may represent a reliabletherapeutic modality in selected patients.
Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalJournal of Endovascular Therapy
Volume20
Publication statusPublished - 2013

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies'. Together they form a unique fingerprint.

  • Cite this

    Pecoraro, F., Puchner, S., Austermann, M., Torsello, G., Bisdas, T., Pecoraro, F., Donas, K. P., Lachat, M., Rancic, Z., Pfammatter, T., & Mayer, D. (2013). CT Angiography at 24 Months Demonstrates Durability of EVAR With the Use of Chimney Grafts for Pararenal Aortic Pathologies. Journal of Endovascular Therapy, 20, 1-6.