Endovascular repair with chimney technique of abdominal aortic aneurysm with hostile aortic neck
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Jang Yong Kim1, Jae Young Park2, Soon Gu Cho3
1Division of Vascular and Endovascular Surgery, Department of Surgery, School of Medicine, The Catholic University of Korea, Seoul 137-040, Korea.
Abstract:
Abdominal aortic aneurysm (AAA) with hostile aortic neck is not a good candidate for conventional endovascular aneurysm repair (EVAR), and a recent paper showed that EVAR with chimney technique (Ch-EVAR) yielded reasonable outcome. We report here a case of successful Ch-EVAR treatment of AAA with hostile neck. An 81-year-old man presented with a 71-mm AAA during evaluation of a gastric ulcer. Aortic neck was 30 mm in diameter, 10-15 mm in length and angulated by 100°. EVAR was performed with chimney stenting to both renal arteries, and the patient recovered after transient hematuria. At one-year follow-up, AAA had increased by 7 mm with delayed type I endoleak control without renal insufficiency. The patient needed close follow-up.
