1. Harbor-UCLA Medical Center
Chimney, Fenestrated or Hybrid for Thoracic and Abdominal Aortic Aneurysms
Rodney White, MD
Harbor-UCLA Medical Center

2. Rodney A. White , MD
Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement or affiliation with the organization(s) listed below.
Affiliation/Financial Relationship
Company
Grant/Research Support
Consulting Fees/Honoraria
Medtronic
Endologix
WL Gore
Volcano
Abbott

3. Juxtarenal Aneurysms 4

4. Fenestrated Grafts

5. Branched Stent Graft 6

6. Fenestrated, Debranching & Chimneys for Aortic Aneurysms
Cook fenestrated devices pioneered branching technologies
- 4 to 6 wks required to custom make devices
- limited availability
-recent introduction of single-center IDE
to evaluate off-shelf fenestrated device

7. Fenestrated Stent Graft
Designed to Treat Short Necks and Juxta-Renal AAA
Fits in Existing Main Body Device
Off the Shelf Design
Cobalt Chromium ePTFE Covered Balloon Expandable Stents for Renals 8

8. Delivery System Design
Integrated 6.5Fr sheaths
Compatible with various guidewires and guides
Renal cannulation prior to device deployment

10. Debranching

11. Criado FJ, et al. Technical Solutions fro Common Problems in TEVAR:
Managing Access and Aortic Branches. J Endovasc Ther 2009;16(Suppl 1)

13. Pre-procedure
4 days post-deployment

14. Chimney Grafts

15. Danos,et al, Use of Abdominal Chimney Grafts Is Feasible and Safe:
Short-term Results. J Endovasc Ther 2010;17:

16. Loboto, Sandwich Technique for Aortoiliac Aneurysms Extending
to the Internal Iliac Artery or Isolated Common/Internal Iliac Artery
Aneurysms: A New Endovascular Approach to Preserve Pelvic
Circualtion 2011;18:

18. 8.4 cm R. Common
Iliac Aneurysm
6.7 cm L. Common
Iliac Aneurysm

20. 18Fr sheath L.
Lunderquist wire MB x2
Stiff Glide buddy wire
in contralateral Int Iliac
Avoid internal stent struts
Sizing cath R.

21. “kissing” balloon dilation

22. Second 16mm x 55mm limb extension
Contralateral sheath injection

23. Completion angiogram

24. Criado, Chimney Grafts and bare stents: Aortic Branch preservation
Revisited. J endovasc Ther 2007;14:823-24

25. Fenestrated, Debranching & Chimneys for Thoracoabdominal Aneurysms
Evolving technology – no approved devices
Long-term durability has not been demonstrated