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Updated: May 23, 2026

Using a Chemical Biopsy for Graft Quality Assessment

Using a Chemical Biopsy for Graft Quality Assessment

Published on: June 17, 2020

The chimney graft, a systematic review.

Jip L Tolenaar¹, Jasper W van Keulen, Santi Trimarchi

¹Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.

Annals of Vascular Surgery

|April 14, 2012

Summary

The chimney procedure is a viable endovascular option for emergency aortic aneurysm repair in patients with challenging anatomy. While short-term results are promising, long-term outcomes require further investigation.

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Area of Science:

Vascular Surgery
Endovascular Interventions
Aortic Aneurysm Repair

Background:

A significant portion of patients are ineligible for standard endovascular aneurysm repair due to aortic neck morphology.
Challenging aortic anatomy, particularly near side branches, often necessitates complex open surgery.
Fenestrated/branched stent grafts offer endovascular solutions but are time-consuming and costly.

Purpose of the Study:

To evaluate the short- and long-term efficacy and safety of the chimney procedure.
To assess the chimney procedure as an alternative for patients with challenging aortic anatomy.

Main Methods:

A systematic literature review was conducted using MEDLINE and Excerpta Medica Database.
Studies were critically appraised for relevance, validity, and outcome measures.

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Last Updated: May 23, 2026

Using a Chemical Biopsy for Graft Quality Assessment

Using a Chemical Biopsy for Graft Quality Assessment

Published on: June 17, 2020

Patient data, surgical techniques, and outcomes were analyzed.

Main Results:

75 patients underwent the chimney procedure, preserving 96 branches, with a 98.9% technical success rate.
Three perioperative deaths occurred, one related to the intervention.
Follow-up ranged from 2 days to 54 months, with three late deaths (none device/aneurysm related) and three graft occlusions (two requiring reintervention).

Conclusions:

The chimney procedure is an acceptable endovascular alternative in emergency settings for patients with challenging aortic anatomy.
Further data on long-term follow-up are needed to fully establish its durability.