Presentation
Coronary artery bypass surgery, endovascular repair of an abdominal aortic aneurysm and femoro-femoral crossover bypass grafting didn't stop this man from smoking ...
Patient Data
After endovascular repair of an abdominal aortic aneurysm, you can see:
the frame of the covered aortic stent
chimney grafts to the superior mesenteric artery and the left renal artery (right kidney is not perfused)
stents in the common iliac arteries with occlusion of the right-sided stent
a femoro-femoral crossover graft bypassing the occlusion of the right common iliac artery
Case Discussion
A covered stent is deployed parallel to the main aortic stent-graft, protruding somewhat proximally, like a chimney, to preserve flow to a vital side branch covered by the aortic stent-graft. The use of a chimney graft makes it possible to use standard off-the-shelf stent-grafts to instantly treat lesions with inadequate fixation zones, providing an alternative to fenestrated stent-grafts in urgent cases, in aneurysms with challenging neck morphology, and for reconstituting an aortic side branch unintentionally compromised during endovascular repair 1.
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