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Endovascular Aortic Repair With the Chimney Technique Using the Ultra Low–Profile Ovation Stent-Graft for Juxtarenal Aneurysms Having Small Iliac Access Vessels

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Abstract

Purpose

To report the first experience using the chimney technique in combination with the latest-generation low-profile stent-graft to seal abdominal aortic aneurysms having a very short neck (proximal sealing zone) and difficult access due to very small iliac vessels.

Materials and Methods

Use of an ultra low-profile 14F delivery aortic stent-graft system (Ovation; Trivascular, Santa Rosa, CA) with chimneys to the lowermost renal arteries in two patients who were not anatomically suitable for endovascular aortic aneurysm repair (EVAR) and too frail for open surgery.

Results

Implantation of stent-grafts and chimneys was technically successful without endoleak or other postinterventional complications. Follow-up after >1 year confirmed complete aneurysm exclusion, shrinkage of the aneurysm sac, and patent renal perfusion by way of the chimney.

Conclusion

Ultra low–profile aortic stent-graft systems are particularly helpful in case of inadequate small iliac access vessels and allow EVAR for short-necked aortic aneurysms if technical contraindications obviate FEVAR and physical impairment discourages open surgical repair.

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Conflict of interest

Dr. med. Alexander Massmann and Prof. Dr. med. Arno Buecker have nothing to disclose. Ferdinand Serracino-Inglott reports personal fees from Trivascular, outside the submitted work.

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Correspondence to Alexander Massmann.

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Massmann, A., Serracino-Inglott, F. & Buecker, A. Endovascular Aortic Repair With the Chimney Technique Using the Ultra Low–Profile Ovation Stent-Graft for Juxtarenal Aneurysms Having Small Iliac Access Vessels . Cardiovasc Intervent Radiol 37, 488–492 (2014). https://doi.org/10.1007/s00270-013-0748-2

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