• R Shahverdyan, M Gawenda, and J Brunkwall.
• Department of Vascular Surgery, University Hospital of Cologne, Kerpener Str. 62, D-50937 Cologne, Germany. robert.shahverdyan@uk-koeln.de
• Eur J Vasc Endovasc Surg. 2013 Jan 1; 45 (1): 28-35.

ObjectiveTo report our early experience with total endovascular repair of aortic-arch aneurysm using double chimney-grafts and present a literature overview.Patients And MethodsThe double chimney-graft technique was performed in six male patients with contained ruptured aneurysm, dissecting aneurysm, pseudoaneurysm, penetrating aortic ulcer and proximal endoleak after TEVAR. Furthermore, a systematic electronic health database search of available articles was conducted according to PRISMA Guidelines.ResultsIn all cases, all supra-aortic vessels had to be covered with aortic stent-graft to receive a sufficient landing and sealing zone. Chimney-grafts were introduced to the ascending aorta slightly deeper than the thoracic stent-grafts through the cut-down exposure of the common carotid arteries. We deployed aortic stent-grafts and self-expandable chimney-grafts simultaneously and successfully. The patient with contained ruptured aneurysm died due to cardiopulmonary failure on day 19, the others survived. We detected two 'gutter' endoleaks. As a result of literature search, 12 articles met the inclusion criteria. Two articles described the double-chimney technique.ConclusionsThe use of double chimney-grafts is possible in high-risk patients where the proximal landing zone of endograft would be in zone 0. The available data is still limited. The long-term follow-up remains to be evaluated with the increased number of patients treated.Copyright © 2012 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

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