Retrospective evaluation of renal chimney practice in endovascular aort replacement

Objectives: In this study It is aimed to demonstrate whether the chimney method, which is preferred in cases where the renal circulation will be disturbed by routine endovascular methods, can be used with confidence, whether the graft opening is provided at the desired level and if so, to determine the factors affecting graft patency. Methods: Patients who underwent renal chimney surgery between June 2009 and March 2016 were evaluated retrospectively. A total of 29 patients were included in the study. Demographic data, comorbidities, preoperative and postoperative aneurysm size, aneurysm type, operation details, hospital and intensive care unit stay, preoperative and postoperative renal function data, postoperative management and follow-up CT angiographies were retrospectively screened. Results: A total of 29 patients with 41 renal chimney grafts included in this study. The median age of the patients included was 72 years (65 - 73). 21 hasta juksta renal abdominal aort anevrizması (%72,4), 4 hasta Crawford tip IV (%13,8), 1'er hasta (%3,4) ise Crawford tip I ve tip III torakoabdominal aort anevrizması, 1 hasta (%3,4) akut tip III diseksiyon, 1 hasta da anastomoz kaçağı nedeniyle opere edilmiştir. 21 patients were juxtarenal abdominal aortic aneurysm (%72,4), 4 patients were Crawford type IV (%13,8), 1 patient was Crawford type I(%3,4), 1 patient was Crawford type III (%3,4), 1 patient was (%3,4) acute type III dissection and 1 patient was diagnosed with anastomosis leakage (%3,4). At a mean follow-up of 430 days 6 months chimney graft patency was 97,3% and 3 years chimney graft patency was 70,6%. Conclusion: The renal chimney method is a lower cost method than the fenestrated graft technique that can be used in emergency conditions and does not require patient-specific material production. The chimney method can be used safely with low rates of type I endoleak.