Comparison of fenestrated endovascular aneurysm repair and chimney graft techniques for pararenal aortic aneurysm

Abstract

In this limited retrospective series, short-term and midterm results of f-EVAR and c-EVAR were not statistically different. c-EVAR could be an attractive option for patients not suitable for f-EVAR.

Impact of Renal Artery Angulation on Procedure Efficiency During Fenestrated and Snorkel/Chimney Endovascular Aneurysm Repair

“…10 Available data to date, consisting of two single series and two meta-analyses, have been unable to demonstrate any reliable difference in these two approaches as it pertains to cannulation failure, target branch vessel patency, early mortality, type I endoleak, postoperative renal dysfunction, and need for secondary reintervention. 9,[14][15][16] As the debate continues regarding f-EVAR vs s/c-EVAR, one of the major differences between the two strategies is the cranial or caudal approach toward the target renal artery, which often makes cannulation a rate-limiting step in the efficiency and complexity of the repair. Moreover, the potential differences between the technical ease with which either procedure can be performed may have downstream effects on procedure time and radiation exposure that may ultimately favor one approach over another.…”

Endovascular Chimney Technique for Juxtarenal Abdominal Aortic Aneurysm: A Systematic Review Using Pooled Analysis and Meta-Analysis

“…5,10 However, the major concerns with chimneys are endoleaks and complications. 10,12 The risks of migration and the complications include the loss of chimney patency, which may occur during follow-up. 12,13 Nevertheless, there is not enough statistics analysis or reviews that show the operational efficiency of Ch-EVAR till now.…”

“…10,12 The risks of migration and the complications include the loss of chimney patency, which may occur during follow-up. 12,13 Nevertheless, there is not enough statistics analysis or reviews that show the operational efficiency of Ch-EVAR till now. 14,15 This article was aimed to primarily evaluate the safety and efficacy of Ch-EVAR for JAAA by performing a systematic analysis on the relevant literature.…”

Invited commentary

“…Kastargyris 1 and Donas 2 have both performed literature-pooled analysis suggesting similar aortic and systemic outcomes for chEVAR and fEVAR, except for slightly higher chEVAR stroke rates with transarch access from the arms. Banno et al 3 have just now communicated as much in their large single-center report of chEVAR compared with fEVAR out to 1 year. What is different here is the suggestion of significant later failure.…”