Chimney grafts for endovascular repair of aortic dissection involving the aortic arch

Objective To assess the use and outcomes of chimney grafts inserting into the left carotid artery in endovascular repair of aortic dissection.Methods The clinical data of 8 patients with aortic dissection [7 male, 1 female with average age (47.25±15.35) (29-71) years] hospitalised in our hospital from June 2009 to February 2010 were analysed retrospectively. They all suffered from aortic dissection that did not have adequate proximal zone for sealing the stent the stent. These patients were managed by endovascular repair combined with placement of chimney grafts to restore flow of the aortic branches which were intentionally covered. Follow-up examinations was made by spiral computer tomography. Results All the 8 operations were clinically successful after treatment, and no patient died in the perioperative period. Type II endoleaks occurred in 2 patients, but one disappeared in 2 weeks, while one persisted but decreased in size at 5 months postoperatively. During the follow-up of 2-10 months postoperatively, spiral CT showed patency of all stent-grafts, enlargement of true lumen and compression of false lumen. No other complications occurred. Conclusions Endovascular repair combined with protecting aortic branches by chimney grafts for aortic dissection with inadequate proximal sealing zones seems promising at short-term follow-up. More cases and data are needed to evaluate the safety and efficiency of this technique.