Trans-femoral chimney technique using a steerable sheath for endovascular repair of juxtarenal abdominal aortic aneurysm

For patients with a juxtarenal abdominal aortic aneurysm (JAAA), the chimney technique is an alternative treatment option to open surgical repair. Although the chimney technique is feasible in most cases of JAAA, some anatomical situations may challenge the implantation of a chimney graft through the traditional upper extremity access. Herein, we present a trans-femoral chimney technique using a steerable sheath for chimney endovascular aneurysm repair (chEVAR) of JAAA. This technique allows chEVAR to be completed safely without upper extremity access even in patients at high risk of cerebral embolism including those with a shaggy aorta.