The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture

• Published in: Journal of vascular surgery Vol. 53; no. 5; pp. 1386 - 1390
• Main Authors: Schlösser, Felix J.V., MD, PhD, Aruny, John E., MD, Freiburg, Carter B., MD, Mojibian, Hamid R., MD, Sumpio, Bauer E., MD, PhD, Muhs, Bart E., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2011; Elsevier
• Subjects: Aged; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - surgery; Aortic Rupture - diagnostic imaging; Aortic Rupture - surgery; Aortography - methods; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Blood Vessel Prosthesis Implantation - methods; Cardiology. Vascular system; Celiac Artery - diagnostic imaging; Diseases of the aorta; Endoleak - etiology; Endoleak - surgery; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Female; Humans; Medical sciences; Mesenteric Arteries - diagnostic imaging; Prosthesis Design; Reoperation; Stents; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels; Cardiovascular disease; Endovascular route; Aortic aneurysm; Surgery; Rupture
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2010.11.097

A 79-year-old woman presented with a ruptured saccular thoracoabdominal aortic aneurysm involving the celiac and mesenteric artery. The patient was unfit for open surgical repair. A “chimney” procedure was performed, which involved placement of stents in the aortic side branches alongside the endograft. The patient underwent another chimney procedure 2 weeks later for a type I endoleak. Computed tomography angiography (CTA) at 1 and 6 months showed a good result with no endoleaks or graft migration. The chimney procedure provides an alternative for emergency patients unfit for open repair and has the advantage that stents can be used that are already available in most institutions.