Chimney stent grafts in the era of custom-made devices: A comparative review of complex abdominal aortic aneurysm stenting

Introduction: Surgical treatment of abdominal aortic aneurysms (AAA) has evolved over the past 15 years. Fenestrated endovascular of AAAs (FEVAR) and Chimney endovascular of AAA (Chimney EVAR) are techniques that have been introduced and utilized over the past few years as alternatives to open surgical repair with its high associated morbidity and mortality. The purpose of this study is to compare the results of FEVARs and Chimney endografts in a single institution from an Asian perspective. Materials and Methods: We retrospectively reviewed all patients who underwent FEVAR and Chimney EVAR from January 2011 to August 2014 in a tertiary vascular institution. Results: During this study period, a total of 19 patients underwent Chimney EVAR, and 12 patients underwent FEVAR. All FEVAR patients were operated electively while five patients who underwent Chimney EVAR were operated in an emergency setting. Operative time was longer for FEVAR and more vessels were reconstructed. There was no difference in intraoperative technical events, postoperative general and specific complications between the two groups. One patient passed away within 30 days of repair with Chimney EVAR. Conclusion: In this limited retrospective series, short-term results of FEVAR and Chimney EVAR had no statistical difference. Chimney EVAR is an attractive and useful alternative for patients who are unable to undergo FEVAR.