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Outcomes of Chimney and/or Periscope Techniques in the Endovascular Management of Complex Aortic Pathologies

摘要Background:The chimney/periscope technique has been used to address complex aortic pathologies.This study aimed to report the outcomes and experiences of chimney and/or periscope grafts (CPGs) used in the endovascular management of complex aortic pathologies.Methods:Twenty-two patients with complex aortic pathologies were retrospectively studied from January 2013 to August 2016 in two vascular centers of teaching hospitals.All patients were diagnosed using computed tomography angiography (CTA).The patients were followed up at postoperative 1,3,6,and 12 months and yearly thereafter with X-ray,ultrasound,and/or CTA.Results:Twenty-two cases (17 males;mean age 60.7 ± 16.3 years) with complex aortic pathologies were analyzed.Nineteen patients underwent CPGs only,and the other three cases underwent the simultaneous implantation of chimney/periscope and fenestrated/scallop grafts.Twenty-six arteries were managed with forty CPGs during the procedures.Complete angiographies revealed two Type Ⅰ endoleaks,one Type Ⅲ endoleak,and one Type Ⅳ endoleak.Other intraoperative complications included brachial thrombosis,external iliac artery rupture,and left renal stenosis.The 30-day mortality was 0.The mean follow-up was 26.1 ± 10.1 months with a range of 2-39 months.During the follow-up,two Type Ⅰ endoleaks and one Type Ⅳ endoleak were observed.One right renal stent occlusion occurred in the 5th month and turned patent after reintervention.Three patients died during the follow-up,one due to an aneurysm rupture as a Type Ⅰ endoleak,and two due to myocardial infarction.The instant technical success was 96%.The primary and secondary patencies were 92%and 96%,respectively.The overall survival rates were 95%,84%,and 84% at 12,24,and 36 months,respectively.Stent migration was not observed in any patient.Conclusions:Chimney/periscope techniques could be used to tackle complex aortic pathologies,but the indications must be strictly controlled,and additional experiences are required.

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作者单位 Department of Vascular Surgery, Beijing Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China [1] Department of Vascular Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730, China [2]
栏目名称 Original Articles
DOI 10.4103/0366-6999.213410
发布时间 2017-09-27
基金项目
This study was supported by a grant of National Natural Science Foundation of China
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中华医学杂志(英文版)

中华医学杂志(英文版)

2017年130卷17期

2095-2100页

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