Ứng dụng kết hợp CERAB – chimney tái tạo ngã ba động mạch chủ trong tắc mạn chủ – chậu sát động mạch thận: Báo cáo ca lâm sàng

Abstract

Endovascular reconstruction of the aortic bifurcation using the covered endovascular reconstruction of the aortic bifurcation (CERAB) technique combined with the chimney approach represents a minimally invasive option that enables effective revascularization while preserving renal artery patency in selected cases of high-level TASC II D chronic aortoiliac occlusive disease. We report the case of a 54-year-old woman admitted with severe intermittent claudication and rest pain of both lower limbs, corresponding to Rutherford 4. Computed tomography angiography demonstrated chronic total occlusion of the abdominal aorta immediately below the right renal artery extending to both common iliac arteries, associated with left renal artery occlusion and an atrophic left kidney; renal function was impaired with an estimated glomerular filtration rate of 35 mL/min/1.73 m². The patient underwent endovascular treatment using the CERAB technique combined with chimney stent placement to preserve the right renal artery, achieving technical and hemodynamic success. Post-intervention, lower limb ischemic symptoms markedly improved, and renal function increased to an eGFR of 45 mL/min/1.73 m² after one week of follow-up. These findings support the feasibility and effectiveness of the combined CERAB – chimney technique in the management of complex chronic aortoiliac occlusive disease while contributing to renal function preservation.