Chimney Grafts for a Juxtarenal Aneurysm in an Octogenarian Patient with Left Main Coronary Artery Disease and Symptomatic Carotid Stenosis: Case Report

Patients with juxtarenal aneurysms (JAA) require a complex surgical open repair which is associated with increased mortality and morbidity. The chimney procedure has been developed as an easy-to-use method. We present an octogenarian patient with a JAA, unstable angina with severe stenosis of the left main coronary artery, left iliac artery occlusion and symptomatic carotid artery stenosis. He was treated with staged chimney grafts and aorto-uni-iliac stent-grafting in addition to left axillo-femoral bypass following an urgent combined coronary and carotid procedure. He was discharged from hospital on postoperative day 10 without any complications. Chimney grafts are an attractive alternatives in complex situations due to flexibility of this technique, much shorter procedural durations and lack of requirement for custom-built devices.