ChEVAR technique for emergent aneurysm repair - a retrospective case series
| Title: | ChEVAR technique for emergent aneurysm repair - a retrospective case series |
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| Authors: | Carlos Veterano, Pedro Sá Pinto, Carlos Pereira, Joana Martins, Daniel A. Mendes, Henrique Rocha, Andreia Pinelo, Rui Machado |
| Source: | Angiologia e Cirurgia Vascular, Vol 19, Iss 3 (2023) |
| Publisher Information: | Sociedade Portuguesa de Angiologia e Cirurgia Vascular, 2023. |
| Publication Year: | 2023 |
| Collection: | LCC:Medicine LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: | Aortic Aneurysm, Abdominal, Aneurysm, Ruptured, Endovascular Aneurysm Repair, Chimney, Parallel stents, Medicine, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: | INTRODUCTION: Chimney EVAR (ChEVAR) for the treatment of complex abdominal aortic aneurysm (AAA) has been largely relegated for when fenestrated endografts are unavailable, especially due to durability concerns. However, the off-the-shelf nature of ChEVAR makes it a good option for emergent AAA repair. We report our institutional experience in ChEVAR in an urgent setting. METHODS: ChEVAR procedures were collected from 2019 to 2023 in a tertiary hospital, and a retrospective analysis was performed. This includes gathered information from electronic medical records, surgical reports and the picture archiving system. Descriptive statistics were applied. The main endpoints were technical success, 30-day and 1-year survival. RESULTS: Five patients were submitted to urgent aneurysm repair using the chEVAR technique. Average age was 73,4 years and all patients were male. Arterial hypertension was present in 100% patients and all patients were ASA 4. Indications for surgery were post EVAR type 1a endoleak with associated rupture or abdominal pain in two patients; symptomatic/contained rupture of pararenal AAA in two patients; and contained rupture of a thoracoabdominal aneurysm in one patient. A total of eight target vessels were catheterized: two patients required single-vessel chimney and the remainder two-vessel chimney. Target vessels were two superior mesenteric arteries and six renal arteries. Technical success rate was 100% and 30-day mortality was 0%. There were no major complications. Follow-up time is 20.2 months (4.7-38). Target vessel patency during the follow-up period was 87.5%. Three patients (60%) died due to non-aortic related pathologies, on average 18 months after surgery (4.7-38), with a 1-year survival of 80%. CONCLUSION: Our experience with ChEVAR for emergent AAA repair is satisfactory, with high technical success rates and low short-term mortality. Sac regression, low rates of target vessel occlusion and type 1a endoleaks reveal a favourable profile for aneurysm exclusion. ChEVAR is a viable option in emergent setting for patients unfit for open repair. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | Portuguese |
| ISSN: | 1646-706X 2183-0096 |
| Relation: | https://acvjournal.com/index.php/acv/article/view/578; https://doaj.org/toc/1646-706X; https://doaj.org/toc/2183-0096 |
| DOI: | 10.48750/acv.578 |
| Access URL: | https://doaj.org/article/99b981379c614575a4e0f08c30f16aed |
| Accession Number: | edsdoj.99b981379c614575a4e0f08c30f16aed |
| Database: | Directory of Open Access Journals |
| ISSN: | 1646706X 21830096 |
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| DOI: | 10.48750/acv.578 |
| Published in: | Angiologia e Cirurgia Vascular |
| Language: | Portuguese |