“Over-SIRIX”: un nuovo metodo per calcolare l’oversizing delle endoprotesi utilizzando “OsiriX Imaging Software”. Esperienza preliminare nell’impiego di “chimney technique” dell’arco aortico

“Over-SIRIX”: a new method to calculate endograft oversizing by using “OsiriX Imaging Software”. Early experience with chimney technique and TEVAR for the aortic arch diseases Stefano Fazzini, Vittorio Alberti, Sonia Ronchey, Eugenia Serrao, Nicola Mangialardi SAN FILIPPO NERI HOSPITAL, ROME, ITALY STUDY AND PURPOSE The aim of this study is to apply the "Over-SIRIX", a new method to measure oversizing for CHIMPS, not a standard formula. The intention is to minimize the maximum risk of type IA endoleaks, often coming from the gutters. METHOD AND SOURCES From 2002 to 2014 were treated 31 patients with CHIMPS for aortic arch. 19 patients with antegrade single chimney were included, and divided in two groups (PRE/POST) with retrospective and prospective study. The method consists in the study of the proximal neck (MPR), exactly at the level of chimney-graft complex, drawing a circle/oval representing the stent and the perimeter of the endoprosthesis in order to eliminate the "gutters". RESULTS: The average ideal oversizing was of 19.57% (11.4% -27%) and Over-SIRIX 13%; the area of the gutters (cut-off:0.75 cm2) decreased from 0.74 to 0.15 (PRE/POST) and the rate of endoleaks from 28.5% to 0% (PRE/POST). The average neck (26 mm) was comparable between the groups PRE/POST (27/23 mm). CONCLUSION: Over-SIRIX appears to be a simple method that can customize oversizing for CHIMPS reducing the risk of endoleak IA, which is related significantly to the presence and size of the gutters.