Multiple periscope and chimney grafts to treat ruptured thoracoabdominal and pararenal aortic aneurysms

Felice Pecoraro, Felice Pecoraro, Frank J. Veith, Mario Lachat, Thomas Frauenfelder, Lukas Hechelhammer, Zoran Rancic, Thomas Pfammatter, Dieter Mayer, Dimitri Papadimitriou

Risultato della ricerca: Articlepeer review

70 Citazioni (Scopus)

Abstract

Purpose: To report midterm outcomes after urgent endovascular repair of rupturedpararenal or thoracoabdominal aortic aneurysms using multiple periscope and chimneygrafts to preserve renovisceral branch perfusion and facilitate aneurysm exclusion.Methods: Nine consecutive men (mean age 72614 years, range 40–88) presenting withruptured thoracoabdominal (n56), pararenal (n52), or infrarenal (n51) aortic aneurysmunderwent urgent endovascular repair with at least 1 periscope graft delivered via atransfemoral access; chimney grafts were installed from an axillary access. In all, 17periscope and 7 chimney grafts were used to reperfuse 11 renal and 13 visceral arteries inthe 9 patients. The aortic aneurysms were excluded using thoracic devices (n57), an aorticextension cuff (n51), and bifurcated stent-grafts (n52).Results: All procedures were completed without technical complications except for adislocated stent-graft from the right renal artery; the artery could not be re-accessed, andthe right kidney was sacrificed. One patient died of multiple organ failure (11% 30-daymortality). At a mean follow-up of 10 months (range 3–24), 5 of the 9 patients hadrecovered completely; 3 patients died of unrelated causes. Imaging showed no aneurysmgrowth in any patient, with a mean 20% shrinkage in aneurysm size. All periscope andchimney grafts remained patent, and no aortic stent-graft migration was observed. Renalfunction and the glomerular filtration rate remained stable in all patients.Conclusion: The periscope and chimney graft technique provides a simpler, less invasiveway to maintain blood flow to the renovisceral arteries during urgent endovascular aorticrepairs. The very low 30-day mortality rate and the stability of the repairs in the midtermare encouraging. This technique has the potential to profoundly influence the treatment ofacute aortic pathologies.
Lingua originaleEnglish
pagine (da-a)642-649
Numero di pagine8
RivistaJournal of Endovascular Therapy
Volume18
Stato di pubblicazionePublished - 2011

All Science Journal Classification (ASJC) codes

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  • ???subjectarea.asjc.2700.2741???
  • ???subjectarea.asjc.2700.2705???

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