Treatment of a juxtarenal aneurysm with heavily calcified iliac arteries using a fenestrated endograft
This is a case report describing the different steps of the implantation of a fenestrated preloaded endograft to treat a juxtarenal aneurysm with calcified and tortuous iliacs.
Great case Michel! Just a question. Given the age, the increased peri-operative risk of the patient and the hostile iliac anatomy, why not Chimney-EVAR?
to give you a simple answer: because FEVAR was feasible.
This patient would have required at least a double chimney, because the renal artery orifices are on the same level. As you can see on the image of the SMA, there is also some plaque/thrombus burden on the aortic wall, so an adequate treatment would not be possible without using a triple chimney. From the data published we know that the outcome of triple chimneys is not so good.
Aortic Disease Awareness Day