Use of Tube Stent-Grafts Combined with the Chimney Technique in Juxtarenal Saccular Aortic Aneurysms with Sufficient Distal Neck

Use of Tube Stent-Grafts Combined with the Chimney Technique in Juxtarenal Saccular Aortic Aneurysms with Sufficient Distal Neck

Purpose: To present the utility of the chimney technique combined with tube grafts in the management of juxtarenal aortic aneurysms (JAAAs) of saccular shape with long distal neck. Case reports: Three patients, one female and two males presented with symptomatic JAAAs. The CT angiography reveled saccular JAAAs with a proximal neck of < 9 mm and a distal neck with > 20mm in all cases. The therapeutic approach was based on the morphologic characteristics of the aneurysms with placement of triple tube grafts in each case. Use of chimney technique was preferred due to the need for urgent treatment. The patients were treated successfully. No persistent endoleak occurred during the mean follow up of 30.5 months. Conclusion: Properly selected aneurysms with short proximal and long distal neck can be treated with tube endografts in combination with the chimney procedure. This approach may be beneficial for urgent treatment.