Endovascular treatment of paravisceral mycotic aneurysm: Chimmeny endovascular sealing the end of de road

Abstract

Open surgery is the elective treatment for mycotic aneurysms of the aorta. This surgery consists of resection of the aneurysm, debridement and revascularization with an in situ or extra-anatomic bypass. Even when surgery has been successful, the morbi-mortality is raised and the endovascular treatment has become an alternative for specific patients. When mycotic aneurysms involved the visceral arteries, more complex techniques are necessary such as fenestrated endovascular aortic repair or chimmeny endovascular aortic repair and the most frequent complications of this are endoleaks and oclussion the visceral arteries. We present a case of a pacient with a paravisceral abdominal mycotic aneurysms that was result with 2 chimney technique (in the right renal and superior mesenteric arteries) and a single Nellix EVAS (Endologix, Irvine, Calif) of 12 cm long without evidence of endoleaks in the follow-up.

Keywords: Mycototic aneurysms; Edovascular repair; Aorta; Endoleaks; Para visceral aneurysms

Core tip: The interesting of the case that we present is the resolution of the mycotic aneurysms throw a new techniques calls chimmeny endovascular sealing (Ch-EVAS). This case it would be the first case treated with Ch-EVAS that has been reported since in the bibliographical review that we made we do not find cases of paravisceral abdominal mycotic aneurysms treated with this technology.