Chimney technique for aortic arch pathologies: an 11-year single-center experience

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Thoracic Surgery

Background:

• Aortic arch pathologies pose significant treatment challenges.
• Conventional open repair carries high morbidity and mortality.
• Endovascular solutions are increasingly explored for complex aortic disease.

Purpose of the Study:

• To evaluate the safety and efficacy of the chimney technique for aortic arch pathologies.
• To report mid- to long-term outcomes of patients treated with this approach.

Main Methods:

• Retrospective analysis of 26 patients undergoing thoracic endovascular aortic repair (TEVAR) with chimney technique.
• Indications included short proximal landing zones, aneurysms, dissections, and endoleaks.
• Chimney stent-grafts were deployed in arch vessels; follow-up included serial computed tomography scans.

Main Results:

• 100% technical success rate.
• Low incidence of major adverse events; 3 minor strokes and 2 cases of paraparesis.
• Median follow-up of 36.8 months revealed 89.3% chimney graft patency and a 23% type I endoleak rate.

Conclusions:

• The chimney technique is a safe and feasible option for aortic arch pathologies.
• It is particularly valuable for high-risk surgical candidates and emergency cases.
• Long-term surveillance is crucial due to persistent concerns regarding type I endoleaks.