Reparación endovascular de endoleak tipo IA en el arco aórtico mediante endoprótesis paralelas. Endovascular Repair of type IA endoleak in the aortic arch with parallel stenting technique

Introduction. The endoleaks are the most common complication after TEVAR. Different procedures are employed to treat this type of leakage, but the proximity of vital arteries difficult to treat and increases the risk of complications. We present a case in which the technique was used Fireplace (Chimney Graft Technique) to treat a type IA endoleak after TEVAR. Case report. A case of a 73 year old male. Underwent surgery for type A aortic dissection (sternotomy twice) and descending thoracic aortic stent with occlusion of left subclavian artery dissection type B. Admitted for proximal endoleak type IA thoracic stent level, as evidenced by CT angiography of control. Given their high comorbidity, was decided to perform "Chimney Graft Technique", by placing Gore TAG ® endoprosthesis at the level of ascending aorta and aortic arch; partnering Endurant ® stent from ascending aorta to the brachycephalic trunk. To this was added the brachiocephalic revascularization by performing a carotid-carotid bypass right-left. Absence of postoperative complications. After 6 months after surgery, the patient is asymptomatic with patency of stents and carotid-carotid bypass, with no evidence of endoleak on CT angiography of control. Conclusions. Chimney Technique (Chimney Graft Technique) in combination with stents in parallel allows the exclusion of endoleaks otherwise untreatable because of their proximity to visceral branches. However, the number of patients treated so far is limited to draw stronger conclusions about permeability and long-term effectiveness.