OBJECTIVE: The chimney/snorkel endovascular aortic repair (ch-EVAR) is gaining ever-greater acceptance in the treatment of pararenal pathologic processes. However, the published experience includes mainly short-term clinical results with combinations of several abdominal devices and types of chimney grafts. The aim of this study was the midterm evaluation of the Endurant stent graft (Medtronic, Santa Rosa, @entity2948 ) as a standard abdominal device for ch-EVAR. METHODS: Between January 2009 and January 2013, prospectively collected data of high-risk @entity1 with pararenal pathologic processes who underwent ch-EVAR with placement of the Endurant abdominal device were analyzed. The chimney graft intended for use was a balloon-expandable covered stent. Main outcome measures were @entity439 sac regression and chimney graft patency. RESULTS: A total of 187 snorkel/chimney grafts were successfully placed in 128 @entity1 (mean age, 76.6  years). The technical success was 100%. The mean preoperative proximal neck length and @entity439 size were 4.7  mm and 64.8  mm (range, 48-135  mm), respectively. The postoperative new neck length after use of chimney grafts was 18.7     6.3  mm. The mean @entity439 sac decreased significantly (60.8  mm; 95% confidence interval, 2.036-7.084; P  = .001) after a mean radiologic follow up of 24.6     17.4  months. Thirty-day mortality and midterm mortality were 0.8% and 17.2%, respectively. Two @entity1 (1.6%) with single chimneys presented with late new onset of type Ia endoleak and underwent additional tube and multiple chimney placement. Primary chimney graft patency was 95.7%. Freedom from chimney graft-related reinterventions was 93.1%. CONCLUSIONS: Standard use of the Endurant abdominal device for ch-EVAR in >120 @entity1 is associated with high technical success, significant @entity439 sac regression, and low incidence of secondary procedures after 2-year radiologic follow-up. These results will give significant impetus to device selection, facilitating the standardization of technique.

The PROTAGORAS study to evaluate the performance of the Endurant stent graft for XXXX with pararenal pathologic processes treated by the chimney/snorkel endovascular technique.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2948 :: ('9337', 'Gene') :: ['Calif'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm']
@entity1 :: (9606,Species) :: ['patients']
