Chimney grafts preserve visceral flow and allow safe stenting of juxtarenal aortic occlusion Adel Bin Jabr, MD, Björn Sonesson, MD, PhD, Bengt Lindblad,

Slides:

Advertisements

Similar presentations

Regarding “A 10-year institutional experience with open branched graft reconstruction of aortic aneurysms in connective tissue disorders versus degenerative.

Advertisements

Kathleen M. Lamb, MD, Julia Glaser, MD, Phillip Dowzicky, MD, Paul J

Lee J. Goldstein, MD, Combiz Rezayat, MD, Gautam V

A modern series of acute aortic occlusion

Preloaded guidewires to facilitate endovascular repair of thoracoabdominal aortic aneurysm using a physician-modified branched stent graft Gustavo S.

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture Felix J.V. Schlösser, MD, PhD, John E. Aruny,

Endovascular repair of an aortic arch pseudoaneurysm by an atrial septal defect occluder combined with a chimney stent Guangqi Chang, MD, Wei Chen, MD,

Elisabeth Schwierz, MD, Ralf R

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients Joseph.

Acute bilateral renal artery chimney stent thrombosis after endovascular repair of a juxtarenal abdominal aortic aneurysm Salvatore T. Scali, MD, Robert.

Brian G. Peterson, MD, Jon S. Matsumura, MD

Periscope graft to extend distal landing zone in ruptured thoracoabdominal aneurysms with short distal necks Zoran Rancic, MD, PhD, Thomas Pfammatter,

Outcome of visceral chimney grafts after urgent endovascular repair of complex aortic lesions Adel Bin Jabr, MD, PhD, Bengt Lindblad, MD, PhD, Thorarinn.

Technical aspects, current indications, and results of chimney grafts for juxtarenal aortic aneurysms Raphael Coscas, MD, Hicham Kobeiter, MD, Pascal.

Novel technique for endovascular salvage of a folded aortic endograft

Endovascular repair of thoracoabdominal aortic aneurysm using the off-the-shelf multibranched t-Branch stent graft Bernardo C. Mendes, MD, Gustavo S.

Endovascular treatment of contained rupture of a superior mesenteric artery aneurysm resulting from neurofibromatosis type I Célio Teixeira Mendonça,

Covered endovascular repair of the paravisceral aorta

Xiaobai Wang, MD, Yan Zhang, MD, Chengzhi Li, MD, Hong Zhang, MD

Covered endovascular repair of the paravisceral aorta

Early versus late experience in fenestrated endovascular repair for abdominal aortic aneurysm Magnus Sveinsson, MD, Jonathan Sobocinski, MD, PhD, Timothy.

Acute renal artery occlusion: Presentation, treatment, and outcome

Endovascular treatment of TransAtlantic Inter-Society Consensus D aortoiliac occlusive disease using unibody bifurcated endografts Robert M. Van Haren,

Safety and effectiveness of the INCRAFT AAA Stent Graft for endovascular repair of abdominal aortic aneurysms Giovanni Torsello, MD, Dierk Scheinert,

Arne Gerhard Schwindt, MD, Giuseppe Panuccio, MD, Konstantinos P

Seth A. Vernon, MD, William R. C. Murphy, MD, Todd W

Initial experience with the Ventana fenestrated system for endovascular repair of juxtarenal and pararenal aortic aneurysms Andrew Holden, MD, Renato.

Andreas M. Lazaris, MD, Anastasios N. Maheras, MD, Spyros N

Jarod McAteer, MD, Robert Ricca, MD, Kaj H. Johansen, MD, PhD, Adam B

Clinical and radiologic course of symptomatic spontaneous isolated dissection of the superior mesenteric artery treated with conservative management

Endovascular native vessel recanalization to maintain limb perfusion after infected prosthetic vascular graft excision Victor Z. Erzurum, MD, Dan Clair,

Therapeutic management of superior mesenteric artery aneurysms

Kevin J. Bruen, MD, Robert J. Feezor, MD, Michael J

Midterm results from a physician-sponsored investigational device exemption clinical trial evaluating physician-modified endovascular grafts for the treatment.

Efficacy and durability of the chimney graft technique in urgent and complex thoracic endovascular aortic repair Adel Bin Jabr, MD, Bengt Lindblad, MD,

Flow control technique to prevent distal embolization during mechanical thrombectomy Mathew Wooster, MD, Daniel Kloda, DO, Jacob Robison, MD, Joseph Hart,

In situ bending of thoracic stent grafts: Clinical application of a novel technique to improve conformance to the aortic arch Tilo Kölbel, MD, PhD, Nuno.

Elisabeth Schwierz, MD, Ralf R

Retrograde popliteal approach for challenging occlusions of the femoral-popliteal arteries Meng Ye, PhD, MD, Hao Zhang, MD, PhD, Xiaozhong Huang, MD,

Georgios Vourliotakis, MD, PhD, Montse Blanch, MD, Clark J

Placement of a branched stent graft into the false lumen of a chronic type B aortic dissection Dominic Simring, FRACS (Vasc), Jowad Raja, MRCS, FRCR,

Repair of recurrent visceral aortic patch aneurysm after thoracoabdominal aortic aneurysm repair with a branched endovascular stent graft Donald J. Adam,

Treatment of symptomatic isolated dissection of superior mesenteric artery Zhihui Dong, MD, Weiguo Fu, MD, Bin Chen, MD, Daqiao Guo, MD, Xin Xu, MD, Yuqi.

Prolonged renal artery occlusion after endovascular aneurysm repair: Endovascular rescue and renal function salvage Nasim Hedayati, MD, Peter H. Lin,

Hybrid management of ruptured isolated superior mesenteric artery dissecting aneurysm Yoshikatsu Nomura, MD, Masato Yamaguchi, MD, Atsushi Kitagawa,

Endovascular repair of bilateral common iliac artery aneurysms following open abdominal aortic aneurysm repair with preservation of both hypogastric arteries.

Use of a surgeon-modified branched thoracic endograft to preserve an aortorenal bypass during treatment of an intercostal patch aneurysm Jeffrey Jim,

Axillobifemoral bypass and aortic embolization for the treatment of two patients with ruptured infrarenal aortic aneurysms David Coleman, MD, Theodore.

Endovascular treatment of thoracoabdominal aortic aneurysms

One-year follow-up after total endovascular repair of a contained-ruptured thoracoabdominal aortic aneurysm with the sandwich technique Theodosios Bisdas,

New temporary internal introducer shunt for brain perfusion during total endovascular arch replacement with in situ fenestration technique Björn Sonesson,

Outcomes of total endovascular treatment of juxtarenal aortic aneurysms in octogenarians Diogo Silveira, MD, Georgios Pitoulias, MD, Giovanni Torsello,

Severe visceral ischemia and death after multilayer stent deployment for the treatment of a thoracoabdominal aortic aneurysm Rafael Noronha Cavalcante,

Endovascular management of superior mesenteric artery pseudoaneurysm

A modern series of acute aortic occlusion

Mark A. Farber, MD, Robert R. Mendes, MD Journal of Vascular Surgery

Jade S. Hiramoto, MD, Catherine K. Chang, MD, Linda M

Feasibility of the Inoue single-branched stent-graft implantation for thoracic aortic aneurysm or dissection involving the left subclavian artery: Short-

Fenestrated endovascular repair for juxtarenal aortic pathology

Type B aortic dissection after endovascular abdominal aortic aneurysm repair causing endograft collapse and severe malperfusion Vikram Iyer, MD, Mark.

Outcomes of fenestrated endovascular repair of juxtarenal aortic aneurysm Thorarinn Kristmundsson, MD, PhD, Björn Sonesson, MD, PhD, Nuno Dias, MD, PhD,

Common Carotid Artery Thrombosis With Recurrent Cerebral Emboli Treated With Ligation Jacquelenn Stuhldreher, Roberto Calderon, Shahab Toursavadkohi,

Sukgu M. Han, MD, Warren J. Gasper, MD, Timothy A.M. Chuter, MD

The double two-chimney technique for complete renovisceral revascularization in a suprarenal aneurysm Jip L. Tolenaar, MD, Herman J.A. Zandvoort, MD,

Endovascular repair of stent graft collapse by stent-protected angioplasty using a femoral-brachial guidewire Drosos Kotelis, MD, Ruben Lopez-Benitez,

John L. Anderson, Donald J. Adam, MD, Michael Berce, David E. Hartley

Repair of juxtarenal para-anastomotic aortic aneurysms after previous open repair with fenestrated and branched endovascular stent grafts Donald J. Adam,

Complete regression of a symptomatic, mycotic juxtarenal abdominal aortic aneurysm after treatment with fenestrated endovascular aneurysm repair Jonathan.

Uei Pua, MBBS, MMed, FRCR Journal of Vascular Surgery

Repair of superior mesenteric artery bypass pseudoaneurysm with physician-modified fenestrated aortic endograft Tahlia L. Weis Sadoski, MD, PhD, Claudio.

Presentation transcript:

Chimney grafts preserve visceral flow and allow safe stenting of juxtarenal aortic occlusion Adel Bin Jabr, MD, Björn Sonesson, MD, PhD, Bengt Lindblad, MD, PhD, Nuno Dias, MD, PhD, Tim Resch, MD, PhD, Martin Malina, MD, PhD Journal of Vascular Surgery Volume 57, Issue 2, Pages 399-405 (February 2013) DOI: 10.1016/j.jvs.2012.08.108 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 The two main types of juxtarenal aortic occlusive diseases. A, Coral reef plaques. B, Distal aortic thrombosis, usually caused by iliac obstruction. Journal of Vascular Surgery 2013 57, 399-405DOI: (10.1016/j.jvs.2012.08.108) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Stenting a juxtarenal aortic occlusion without applying the “chimney technique” carries a risk of visceral occlusion. A, Intraoperative angiogram during stent deployment. B, After stent deployment, the left renal artery is occluded by emboli. C, Restored renal perfusion after on-table thrombolysis and renal stenting. Journal of Vascular Surgery 2013 57, 399-405DOI: (10.1016/j.jvs.2012.08.108) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Intraoperative angiography of midaortic stenting with chimney technique. A, Undeployed stents parked in the superior mesenteric and both renal arteries from a brachial approach. B, Undeployed aortic stent has been added (arrowhead). C, Visceral stents have been deployed, and the balloons are kept inflated in order to protect the viscera from aortic debris until aortic flow is reestablished. D, The aortic stent has been deployed and is dilated while the visceral balloons are still in place. E, All visceral and aortic stents have been deployed. The visceral balloons were deflated after reestablishment of aortic flow. The visceral stents protrude slightly above the aortic stent. F, Completion angiography demonstrates patent renal, mesenteric, and aortic stents with no residual stenosis. Journal of Vascular Surgery 2013 57, 399-405DOI: (10.1016/j.jvs.2012.08.108) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Patient with excessive midaortic (and iliac) calcification (arrows) stented with chimneys in the right (RR) and left renal (LR) and superior mesenteric arteries (SMA). A, Completion angiography. B, Follow-up computed tomography at 18 months. The CT demonstrates how the massive aortic plaque is pushed posteriorly by the aortic stent (A). The final aortic diameter of 8 mm proved sufficient for this patient, who had external iliac arteries only 5 mm in diameter (not shown). Journal of Vascular Surgery 2013 57, 399-405DOI: (10.1016/j.jvs.2012.08.108) Copyright © 2013 Society for Vascular Surgery Terms and Conditions