The Modified Chimney Technique With a Thoracic Aortic Stent Graft to Preserve the Blood Flow of the Left Common Carotid Artery for Treating Descending Thoracic Aortic Aneurysm and Dissection

다국어 초록 (Multilingual Abstract)

While thoracic endovascular aortic repair is an effective treatment option for descending thoracic aorta pathology, it does have limita-tions. The main limitation is related to the anatomical difficulties when disease involves the aortic arch. A fenestrated, branched aortic stent graft and hybrid operation has been introduced to overcome this limitation, but it is a custom-made device and is time consuming to manufacture. Furthermore, these devices cannot be used in an emergency setting. We report two patients with massive descending thoracic aortic aneurysm and ruptured aortic dissection very near the aortic arch who underwent a procedure which we named the modi-fied chimney technique. The modified chimney technique can be used as a treatment option in such an emergency situation or as a rescue procedure when aortic pathology is involved near the supra-aortic vessels.

참고문헌 (Reference)

• 1 Allaqaband S, "“The chimney graft”-a simple technique for endovascular repair of complex juxtarenal abdominal aortic aneurysms in no-option patients" 75 : 1111-1115, 2010
• 2 Rizvi AZ, "The effect of left subclavian artery coverage on morbidity and mortality in patients undergoing endovascular thoracic aortic interventions: a systematic review and meta-analysis" 50 : 1159-1169, 2009
• 3 Ohrlander T, "The chimney graft: a technique for preserving or rescuing aortic branch vessels in stent-graft sealing zones" 15 : 427-432, 2008
• 4 Greenberg RK, "Should patients with challenging anatomy be offered endovascular aneurysm repair?" 38 : 990-996, 2003
• 5 Feezor RJ, "Risk factors for perioperative stroke during thoracic endovascular aortic repairs (TEVAR)" 14 : 568-573, 2007
• 6 Larzon T, "Experiences of intentional carotid stenting in endovascular repair of aortic arch aneurysms: two case reports" 30 : 147-151, 2005
• 7 Sonesson B, "Endovascular total aortic arch replacement by in situ stent graft fenestration technique" 49 : 1589-1591, 2009
• 8 Chuter TA, "Endovascular repair of the aortic arch" 19 : 188-192, 2007
• 9 Cheng D, "Endovascular aortic repair versus open surgical repair for descending thoracic aortic disease a systematic review and meta-analysis of comparative studies" 55 : 986-1001, 2010
• 10 Malina M, "EVAR and complex anatomy: an update on fenestrated and branched stent grafts" 97 : 195-204, 2008
• 11 Criado FJ, "Chimney grafts and bare stents: aortic branch preservation revisited" 14 : 823-824, 2007