Endovascular Management of Juxtarenal and Pararenal Abdominal Aortic Aneurysms: Role of Chimney Technique

The use of chimney technique in endovascular repair of abdominal aortic aneurysms (ChEVAR) has had a secondary role. Although it was first developed in an emergent/urgent setting, the publication of various important studies has helped overcome scepticism towards this technique in elective procedures. This paper reviews current evidence about ChEVAR, focusing on clinical results, technical notes and comparisons with other techniques. The new ChEVAR findings show favourable mid- and long-term clinical outcomes, even in elective patients. These results, comparable to those related to fenestrated endografts, have been achieved through standardisation in planning and materials. An adequate endograft oversizing associated to the right aortic neck length is fundamental to avoid ChEVAR-related complications, such as type 1a endoleaks. These data indicate that ChEVAR, compared to other complex endovascular treatments, has comparable outcomes along with features that could make it an essential option in every clinical setting.