Identification of optimal device combinations for the chimney endovascular aneurysm repair technique within the PERICLES registry

Abstract

Within the PERICLES registry, use of nitinol/polyester stent graft devices with BECS during chimney endovascular aneurysm repair is associated with improved survival compared with other aortic endografts. However, this advantage was not observed for non-BECS repairs. Repairs incorporating multiple chimney subtypes were also associated with increased mortality risk. Importantly, increasing chimney stent number and bare-metal endolining stents increase chimney occlusion risk, whereas patients treated at low-volume centers have higher risk of type IA endoleak.

Endovascular stent graft repair with chimney technique of an abdominal aortic aneurysm with concomitant horseshoe kidney

“…The ideal stent combination for the ChEVAR still remains controversial; however, a recent study has shown that use of nitinol/polyester stent graft devices with a balloon-expandable covered stent during the ChEVAR is associated with improved survival. [8] This technique has a low early morbidity and mortality rate with high long-term patency rates. [9] In conclusion, the chimney endovascular aneurysm repair should be considered as a feasible option for exclusion of abdominal aortic aneurysms in patients with horseshoe kidney and large accessory renal arteries to maintain the renal circulation entirely.…”

Late conversion after endovascular abdominal aortic aneurysm repair in a patient with Ehlers-Danlos syndrome

“…This condition can also provoke a cerebrovascular event. It is the outcome of the use of chimneys for treatment of aneurysms with endograft that remains unknown 8, 9…”

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

“…The chimney technique still has some issues such as parallel graft combinations, use of multiple stent-grafts, and main graft oversizing. Scali et al 33 reported that use of nitinol/polyester stent-grafts with BECS is associated with better survival compared with other aortic endografts, and repairs incorporating multiple chimney subtypes are associated with increased mortality risk. The data regarding main graft oversizing are improving thanks to in vitro studies that promoted 30% oversizing as the best option even for multiple parallel grafts.…”