Endovascular Treatment Of Juxtarenal Abdominal Aortic Aneurysms Recurring To The "Vent Technique".

Abstract Introduction Juxtarenal abdominal aortic aneurysms represent 15-20% of all AAAs. The gold standard of treatment is represented by open surgical repair (OSR). Patients judged unfit for OSR could be submitted to fenestrated endovascular repair (FEVAR) or chimney technique. FEVAR requires 3-4 weeks for endograft production, a minimal length of 4 mm for proximal aortic neck and a large access vessels diameter, with high costs. Traditional chimney technique, feasible also in urgent cases, has a risk of type IA endoleak, due to the space created between covered stents introduced into visceral arteries and the endograft. Methods In the present paper we report our experience about jAAA treatment in 5 patients, recurring to uncovered bare metal stents associated with the ultra-low profile Ovation endograft. Results No intraoperative complications nor type IA endoleak were recorded. Primary clinical success at 1 month was also 100%. During a mean follow-up period of 12.1 ± 3.6 months (range, 9-15 months) no complications related to aneurysm were recorded. Discussion The technique reported represents a valid endovascular option for jAAA treatment in patients at high risk for OSR. Respect to FEVAR, also urgent patients should be treated. Respect to traditional Ch-EVAR, the risk of type IA endoleak is reduced, with a lower rate of reoperation during follow-up. Preliminary clinical results are promising.