Single chimney for elective endovascular treatment of juxtarenal abdominal aortic aneurysm with favorable asymmetric origin of the renal arteries. Is still valid in the custom-made device’s era?

Abstract

Chimney endovascular aortic repair (ChEVAR) is a useful endovascular alternative for treating juxtarenal abdominal aortic aneurysms (AAA), particularly in cases with favorable anatomy. Case: 75-year-old male with a juxtarenal AAA involving the left renal artery. A successful ChEVAR procedure was performed using a parallel covered stent to preserve the left renal artery and achieve an adequate proximal seal. The postoperative course was favorable, with no complications or renal function deterioration. At the 20-month follow-up, computerized tomography angiography showed no signs of endoleak, a patent renal stent and a decrease in aneurysm sac size. Conclusion: ChEVAR is a feasible option for juxtarenal aneurysms when custom-made devices are unavailable, showing comparable mid- and long-term results. However, careful patient selection is essential to minimize risks such as endoleaks or stent thrombosis.