Document Detail


Treating the paravisceral aorta with parallel endografts (chimneys and snorkels).
MedLine Citation:
PMID:  23206566     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
While excellent results can be achieved with the open repair of juxtarenal and suprarenal aortic aneurysms in good-risk patients, the outcomes in high-risk patients are less favorable. The use of standard infrarenal endografts to treat these patients has been limited due to the absence of a suitable proximal landing zone. Using infrarenal endografts outside the instructions for use has been shown to lead to poorer outcomes with a higher incidence of type I endoleaks and graft migration. Fenestrated and branched endografts are viable options, but until recently have not been commercially available within the United States. In addition, they require meticulous preoperative planning and 4 to 6 weeks to manufacture. This makes them unsuitable for use in the urgent setting. Others have looked at the use of parallel covered stents placed alongside the main endograft body, the "chimney" or "snorkel" graft technique, to allow for continued perfusion to visceral/renal vessels. This technique allows for proximal placement of the landing zone of the main body, while maintaining blood flow to critical branches. The purpose of this article is to review the current literature on chimney grafts, their efficacy, and associated morbidity and mortality.
Authors:
Fahad Shuja; Christopher J Kwolek
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in vascular surgery     Volume:  25     ISSN:  1558-4518     ISO Abbreviation:  Semin Vasc Surg     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8809602     Medline TA:  Semin Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  200-2     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Affiliation:
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, Boston, MA.
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