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CardioVascular and Interventional Radiology

Published in:

01-10-2015 | Case Report

ChEVAS: Combining Suprarenal EVAS with Chimney Technique

Authors: Francesco Torella, Tze Y. Chan, Usman Shaikh, Andrew England, Robert K. Fisher, Richard G. McWilliams

Published in: CardioVascular and Interventional Radiology | Issue 5/2015

Abstract

Endovascular sealing with the Nellix^® endoprosthesis (EVAS) is a new technique to treat infrarenal abdominal aortic aneurysms. We describe the use of endovascular sealing in conjunction with chimney stents for the renal arteries (chEVAS) in two patients, one with a refractory type Ia endoleak and an expanding aneurysm, and one with a large juxtarenal aneurysm unsuitable for fenestrated endovascular repair (EVAR). Both aneurysms were successfully excluded. Our report confirms the utility of chEVAS in challenging cases, where suprarenal seal is necessary. We suggest that, due to lack of knowledge on its durability, chEVAS should only been considered when more conventional treatment modalities (open repair and fenestrated EVAR) are deemed difficult or unfeasible.

Donayre CE, Zarins CK, Krievins DK, Holden A, Hill A, Calderas C, Velez J, White RA. Initial clinical experience with a sac-anchoring endoprosthesis for aortic aneurysm repair. 1. J Vasc Surg. 2011;53:574–82. doi:10.1016/j.jvs.2010.09.009.CrossRefPubMed

Krievins DK, Holden A, Savlovskis J, Calderas C, Donayre CE, Moll FL, Katzen B, Zarins CK. EVAR using the Nellix sac-anchoring endoprosthesis: treatment of favourable and adverse anatomy. Eur J Vasc Endovasc Surg. 2011;42(1):38–46. doi:10.1016/j.ejvs.2011.03.007.CrossRefPubMed

Truijers M, van Sterkenburg SM, Lardenoije JW, Reijnen MM. Endovascular repair of a ruptured pararenal aortic aneurysm using the nellix endovascular aneurysm sealing system and chimney grafts. 294. 2015;22(3):291.

Hughes CO, de Bruin JL, Karthikesalingam A, Holt PJ, Loftus IM, Thompson MM. Management of a type Ia Endoleak With the Nellix Endovascular Aneurysm Sealing System. J Endovasc Ther. 2015;22(3):309–11.CrossRefPubMed

Böckler D, Reijnen MM, Krievins D, Peters AS, Hayes P, De Vries JP. Use of the Nellix EVAS system to treat post-EVAR complications and to treat challenging infrarenal necks. J Cardiovasc Surg (Torino). 2014;55(5):601–12.

Dijkstra ML, Lardenoye JW, van Oostayen JA, Zeebregts CJ, Reijnen MM. Endovascular aneurysm sealing for juxtarenal aneurysm using the Nellix device and chimney covered stents. J Endovasc Ther. 2014;21(4):541–7.CrossRefPubMed

Malkawi AH, de Bruin JL, Loftus IM, Thompson MM. Treatment of a juxtarenal aneurysm with the Nellix endovascular aneurysm sealing system and chimney stent. J Endovasc Ther. 2014;21(4):538–40.CrossRefPubMed

de Bruin JL, Yeung KK, Niepoth WW, Lely RJ, Cheung Q, de Vries A, Blankensteijn JD. Geometric study of various chimney graft configurations in an in vitro juxtarenal aneurysm model. J Endovasc Ther. 2013;20(2):184–90. doi:10.1583/1545-1550-20.2.184.CrossRefPubMed

10.

Niepoth WW, de Bruin JL, Lely RL, Wisselink W, de Vries JP, Yeung KK, Blankensteijn JD. In vitro feasibility of a sac-sealing endoprosthesis in a double chimney graft configuration for juxtarenal aneurysm. J Endovasc Ther. 2014;21(4):529–37.CrossRefPubMed

Title: ChEVAS: Combining Suprarenal EVAS with Chimney Technique
Authors: Francesco Torella
Tze Y. Chan
Usman Shaikh
Andrew England
Robert K. Fisher
Richard G. McWilliams
Publication date: 01-10-2015
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 5/2015
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-015-1189-x

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Springer Medicine

ChEVAS: Combining Suprarenal EVAS with Chimney Technique

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

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