Siani Andrea, Accrocca Federico, Gabrielli Roberto, Marcucci Giustino
Unit of Vascular and Endovascular Surgery, San Paolo Hospital, Civitavecchia, Rome, Italy.
Interact Cardiovasc Thorac Surg. 2013 May;16(5):692-4. doi: 10.1093/icvts/ivs572. Epub 2013 Jan 18.
The chimney graft (CG) technique, based on the deployment of a covered stent parallel to the aortic endograft, has been proposed to achieve a safe proximal fixation extending the sealing zone. We report our experience with the CG technique in an emergency setting. Between December 2010 and April 2012, 4 patients underwent the CG technique. The mean age was 79 (range 76-82 years) and 3 patients were men. The median aneurysm diameter was 64.7 mm (range 63-68 mm). Indications for CG were painful proximal para-anastomotic aneurysm in 2 cases and symptomatic juxtarenal aneurysm in the other 2. Target vessels were both the renal arteries. Technical success was achieved in 100% and no intraoperative complications occurred. No stent-related complications, or Type I endoleak, were detected. No death occurred during the postoperative course. Creatinine elevation was observed in 2 cases. At follow-up, no endoleaks or rupture occurred. One patient died of myocardial infarction 3 months after the procedure. The primary patency rate of covered stents was 100%. The CG technique seems to be safe and feasible with an excellent patency rate of covered stents and a low incidence of endoleaks. More evidence in the literature is needed to carry out a validation of this technique in an emergency.
烟囱式移植物（CG）技术是在主动脉腔内移植物旁平行置入覆膜支架，旨在实现安全的近端固定，扩大密封区。我们报告了在紧急情况下应用CG技术的经验。2010年12月至2012年4月期间，4例患者接受了CG技术治疗。平均年龄为79岁（范围76 - 82岁），3例为男性。动脉瘤中位直径为64.7 mm（范围63 - 68 mm）。CG的适应证为2例近端吻合口旁疼痛性动脉瘤和另外2例有症状的近肾动脉瘤。目标血管均为肾动脉。技术成功率达100%，术中无并发症发生。未检测到与支架相关的并发症或I型内漏。术后过程中无死亡发生。2例患者出现肌酐升高。随访期间，无内漏或破裂发生。1例患者术后3个月死于心肌梗死。覆膜支架的一期通畅率为100%。CG技术似乎安全可行，覆膜支架通畅率极佳，内漏发生率低。在紧急情况下对该技术进行验证还需要更多的文献证据。
