Preservation of aortic arch branches using chimney and sandwich stent grafts.

PURPOSE To share our hybrid endovascular experiences using chimney or sandwich stent grafts for acute aortic arch pathologies. METHODS Hybrid procedures for a distal aortic arch aneurysm and an ascending anastomotic aortic aneurysm rupture were reported. Right to left common carotid and left axillar artery bypasses were located. Covered stents were inserted into the inominate artery, with the flow-proximal end located in the ascending (standard chimney) or the descending aortic stent graft (retrograde sandwich). RESULTS Both cases had no signs of brain ischemia. Aneurysms are decreasing in size. CONCLUSION Chimney and sandwich techniques were technically feasible in the complex and acute situations.