Crossover chimney technique to preserve the internal iliac artery during endovascular repair of iliac or aortoiliac aneurysms: midterm results

J Endovasc Ther. 2015 Jun;22(3):388-95. doi: 10.1177/1526602815581596. Epub 2015 Apr 15.

Abstract

Purpose: To report our midterm results of the crossover chimney technique to preserve the internal iliac artery (IIA) in patients with aortoiliac aneurysms (AIA) and isolated common iliac artery aneurysms (CIAA).

Methods: Between May 2012 and January 2014, 14 consecutive patients (mean age 77.3 years; all men) with 17 AIA, isolated CIAAs, or abdominal aortic aneurysms with short CIAs underwent elective endovascular aneurysm repair (EVAR) with the crossover chimney technique to preserve the IIA. Follow-up assessment, including computed tomographic angiography or duplex ultrasound, was performed at 1, 6, and 12 months and annually thereafter.

Results: Technical success, defined as successful preservation of IIA without intraoperative type I or III endoleak, was 100%. Over a mean 14.3 months (range 6-21), primary patency was 92.8%. There was no early or late procedure-related mortality. Among the 17 iliac aneurysms excluded, the sac diameter significantly (at least 5 mm) decreased in 3, decreased <5 mm in 10, and did not change in 4.

Conclusion: The crossover chimney technique is a simple and safe alternative for IIA endovascular revascularization with high technical success and acceptable midterm patency.

Keywords: abdominal aortic aneurysm; aortoiliac aneurysm; chimney graft; common iliac artery aneurysm; endovascular aneurysm repair; internal iliac artery; self-expanding stent-graft.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / diagnosis
  • Aortic Aneurysm, Abdominal / physiopathology
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / methods*
  • Elective Surgical Procedures
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / methods*
  • Humans
  • Iliac Aneurysm / diagnosis
  • Iliac Aneurysm / physiopathology
  • Iliac Aneurysm / surgery*
  • Male
  • Retrospective Studies
  • Taiwan
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex
  • Vascular Patency