Chimney grafts in renal arteries: a clinical model for coronary perfusion in future transcatheter aortic root repair techniques

Ferrari, Enrico; Wang, Changtian; Berdajs, Denis; Segesser, Ludwig Karl von

doi:10.1186/s13019-020-01184-1

Cited by 3 publications

(1 citation statement)

References 33 publications

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“…In this study, 23 patients underwent Ch-EVAR to reconstruct 28 branching arteries (20 renal arteries and 1 superior mesenteric artery). Postoperative the type Ia endoleak was 13% which were satisfactory and consistent with the results reported internationally [17][18][19]. Meanwhile the long-term follow-up results of our center showed that the patency rate of chimney stent was 100%, which may be related to our adherence to long-term postoperative antiplatelets therapy.…”

Section: Discussionsupporting

confidence: 88%

Comparison of Standard Endovascular Repair and Chimney Graft for Juxtarenal Abdominal Aortic Aneurysm

Mingshan,

Huoying,

Zhen

et al. 2023

J Cardiothorac Surg Ther

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Objective: This study compared the efficacy of standard grafting (S-EVAR) and chimney grafting (Ch-EVAR) for treating juxtarenal abdominal aortic aneurysms (JAAA).Methods: Data of patients with JAAA, who underwent S-EVAR and Ch-EVAR from January 2015 to December 2021, were collected. Follow-up was performed by CTA and intravascular ultrasonography of the aorta was performed before discharge, at 6 and 12 months postoperatively, and annually thereafter. Main outcome measures: AAA-related mortality, type Ia endoleak and reoperation.Results: A total of 62 patients underwent S-EVAR and 23 underwent Ch-EVAR. The proportion of men who underwent S-EVAR (91.9%, 57/62) was higher than the proportion who underwent Ch-EVAR (69.6%, 16/23) (p = 0.023). The postoperative incidence rate of type Ia endoleak was lower in S-EVAR (9.7% vs. 13%, p = 0.698). Times for hospitalization, ICU monitoring, operation, and anesthesia, and perioperative bleeding were less in S-EVAR (12 vs. 17 days, 0 vs. 1 day, 122.5 vs. 220 min, 177.5 vs. 300 min, 50 vs. 100 mL, p < 0.05). In S-EVAR, a suprarenal aortic angle was associated with type Ia endoleak (p = 0.016). Median follow-up duration was 48 months, (range, 0-94 months) in the S-EVAR group and 42 months (range, 0-90 months) in the Ch-EVAR group. 1-year survival rate were (91.9% vs. 91.3%), 3-year survival rate (81.7% vs. 78.7%), 5-year survival rate (62.2% vs. 45.8%) were not statistically different. No significant differences were found in postoperative complications. The long-term patency rate of chimney stent was 100%. Conclusions:The off-label use of S-EVAR for JAAA, with a straight and 8-10 mm aortic neck length, can be considered safe and effective. Ch-EVAR is more suitable for JAAA with excessive twisting of the neck (suprarenal aortic angle < 114°). In this study, long-term data of both technologies showed satisfactory results in preventing aneurysm rupture and the related mortality.

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Section: Discussionsupporting

confidence: 88%

Comparison of Standard Endovascular Repair and Chimney Graft for Juxtarenal Abdominal Aortic Aneurysm

Mingshan,

Huoying,

Zhen

et al. 2023

J Cardiothorac Surg Ther

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Is the Mid-Term Patency Rate of Small-Diameter Viabahn Stent-Grafts in Peripheral Artery Disease Related to Their Length? A Systematic Review

et al. 2023

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Objective: Small-diameter endografts can be used for the treatment of the peripheral vascular disease, but the patency rate during the follow-up is still under debate. With this review, we aimed at analyzing the mid-term patency of small-diameter Viabahn stent-grafts and investigating the relationship between patency and the length of the graft. Methods: We performed a review of articles published until September 2020 and reporting use of ≤7-mm-diameter Viabahn stent-grafts in diseased peripheral arteries. Data on study type, demographic, lesion length, stent-graft diameter, length, and patency (1-year, 3-year, 5-year primary patency, primary-assisted patency, and secondary patency), follow-up, endoleak, and re-intervention rates were extracted and analyzed. A statistical test was applied to identify a correlation between stent-graft length and patency. Results: 16 retrospective and 7 prospective studies reported the outcome of 1613 patients (mean age: 69.6±33.7 years). There was considerable heterogeneity in reporting standards among studies. The diameter of Viabahn stent-grafts ranged 5 to 7mm and the average length was 23.6±12.4cm. Heparin-bonded grafts were used in 46.4% of cases. Mean follow-up time was 26.4±17.6 months. The 1- and 5-year primary patency rate was 75.7% (95% CI, 73.6%–77.8%) and 46.8% (95% CI, 41.0%–52.6%), respectively. The 1- and 5-year primary-assisted patency rate was 80.9% (95% CI, 73.9%–87.8%) and 60.9% (95% CI, 46.4–75.5%), respectively. The 1- and 5-year second-assisted patency was 90.4% (95% CI, 87.4%–93.3%) and 73.7% (95% CI, 64.7%–82.8%), respectively. No correlation between the stent-graft length and patency was found. Conclusions: Small-diameter Viabahn stent-graft implantation represents a safe treatment for patients with peripheral artery disease, and the mid-term patency rate seems not be affected by the length of the graft. Clinical Impact The use of small diameter stent-grafts for peripheral vascular disease is an established technique but the patency rate is still under debate. With this review we have investigated the relationship between the mid-term patency and the diameter of the stent-grafts. Afterv having analysed data from 23 published studies including 1613 patients we can conclude that the treatment of the peripheral artery disease with small diameter stent-grafts is safe and the mid-term patency rate seems not be affected by the lenght of the grafts.

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Comparison of standard endovascular repair and chimney graft for juxtarenal abdominal aortic aneurysm

Wang,

Cai,

Liu

et al. 2024

Preprint

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Objective This study compared the efficacy of standard grafting (S-EVAR) and chimney grafting (Ch-EVAR) for treating juxtarenal abdominal aortic aneurysms(JAAA). Methods Data of patients with JAAA, who underwent S-EVAR and Ch-EVAR from January 2015 to December 2021 were collected. Follow-up was performed by CTA and ultrasonography of the aorta were performed before discharge, at 6 and 12 months postoperatively, and annually thereafter. Main outcome measures: AAA-related mortality, type Ia endoleak and reoperation Results A total of 62 patients underwent S-EVAR and 23 underwent Ch-EVAR. The proportion of men who underwent S-EVAR (91.9%, 57/62) was higher than the proportion who underwent Ch-EVAR (69.6%, 16/23) (p = 0.023). The postoperative incidence rate of type Ia endoleak was lower in S-EVAR (9.7% vs 13%, p = 0.698). Times for. hospitalization, ICU monitoring, operation, and anesthesia, and perioperative bleeding were less in S-EVAR (12 vs 17 days, 0 vs 1 day, 122.5 vs 220 min, 177.5 vs 300 min, 50 vs 100 mL, p < 0.05). In S-EVAR, a suprarenal aortic angle was associated with type Ia endoleak (p = 0.016). Median follow-up duration was 48 months, (range, 0–94 months) in the S-EVAR group and 42 months (range, 0–90 months) in the Ch-EVAR group. 1-year survival rate were (91.9% vs 91.3%), 3-year survival rate (81.7% vs 78.7%), 5-year survival rate (62.2% vs 45.8%) were not statistically different. No significant differences were found in postoperative complications. The long-term patency rate of chimney stent was 100%. Conclusions The off-label use of S-EVAR for JAAA, with a straight and 8–10 mm aortic neck length, can be considered safe and effective. Ch-EVAR is more suitable for JAAA with excessive twisting of the neck (suprarenal aortic angle < 114°). In this study, long-term data of both technologies showed satisfactory results in preventing aneurysm rupture and the related mortality.

show abstract

Chimney grafts in renal arteries: a clinical model for coronary perfusion in future transcatheter aortic root repair techniques

Cited by 3 publications

References 33 publications

Comparison of Standard Endovascular Repair and Chimney Graft for Juxtarenal Abdominal Aortic Aneurysm

Comparison of Standard Endovascular Repair and Chimney Graft for Juxtarenal Abdominal Aortic Aneurysm

Is the Mid-Term Patency Rate of Small-Diameter Viabahn Stent-Grafts in Peripheral Artery Disease Related to Their Length? A Systematic Review

Comparison of standard endovascular repair and chimney graft for juxtarenal abdominal aortic aneurysm

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