Chimney Endovascular Aortic Repair (CHEVAR)

What is CHEVAR?

Chimney Endovascular Aortic Repair (CHEVAR) is an advanced minimally invasive technique designed to treat complex aortic aneurysms that involve branch arteries, such as the renal or mesenteric arteries. The procedure uses additional stents, known as "chimneys," alongside the main stent graft to ensure continued blood flow to vital branches while addressing the aneurysm.

Key Differentiators

Allows treatment of aneurysms near vital arteries without open surgery
Chimney stents maintain blood flow to branch vessels
Highly customizable to individual patient anatomy
Minimally invasive with reduced recovery time

Indications for CHEVAR

CHEVAR is indicated for patients with:

Juxtarenal Aneurysms: Located near the renal arteries
Thoracoabdominal Aneurysms: Spanning both the thoracic and abdominal aorta
Failed Prior Repairs: Patients with prior open or endovascular procedures
Anatomical Constraints: Where standard EVAR is not suitable

How is CHEVAR Performed?

The CHEVAR procedure involves the following steps:

Preoperative Planning: Imaging studies to map the aneurysm and surrounding arteries.
Access: Small incisions in the groin or arms to access the femoral and brachial arteries.
Stent Placement: Deployment of the main stent graft and chimney stents to ensure blood flow to branch arteries.
Alignment: Careful positioning of stents using advanced imaging.
Closure: Sealing of all access points and confirming stent stability.

Benefits of CHEVAR

Minimally invasive alternative to open surgery
Preserves blood flow to critical branch vessels
Shorter hospital stays and faster recovery
Customizable to match patient-specific anatomy
Effective in treating complex aneurysms

Risks and Complications

Potential risks of CHEVAR include:

Endoleak: Persistent blood flow into the aneurysm
Chimney Stent Misalignment: Improper positioning of branch stents
Blood Clots: Formation of clots near stent grafts
Kidney Function Issues: Related to temporary blood flow changes during the procedure
Infection: Rare but possible at incision sites

Recovery After CHEVAR

Key aspects of recovery include:

Monitoring in the hospital for 1-3 days
Gradual return to normal activities within 2-3 weeks
Regular imaging follow-ups to assess stent graft and aneurysm stability
Medications to control blood pressure and prevent complications

Conclusion

CHEVAR is a cutting-edge option for treating complex aortic aneurysms involving branch arteries. Its minimally invasive nature and ability to preserve vital blood flow make it a valuable solution for patients with challenging anatomical conditions, ensuring improved outcomes and quality of life.