Video Of Three-vessel Chimney-EVAR
Jonathan Bath, Todd R. Vogel.
University of Missouri, Columbia, MO, USA.
This is a video of a complex Type IV thoracoabdominal aneurysm following previous EVAR. The patient has undergone liver transplant and is taking immunosuppressant medications. He was deemed better suited to complex endovascular aortic repair. Three vessel chimney-EVAR was planned with cranially directed SMA and left renal chimney and caudally-directed right renal periscope into the previous EVAR with a TEVAR bridging piece. Herein we describe the important features of how we perform these complex chimney-EVAR cases at the University of Missouri. We believe the video describes the important features of this type of repair, based upon our rich experience with these cases. We hope to engage the audience with this interesting approach with questions regarding the technique, indications and discussion regarding the long-term durability and morbidity of these approaches when compared with traditional open TAAA repair, commercially-available and physician-modified devices.
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