How do you repair type i endoleak of aaa with secondary juxtarenal aa developed? the aaa size is 10.2 cm. my age is 76 yrs. is the chimney method a long lasting solution? what anatomic criteria needs to be met for open surgery?

Need details : It can sometimes be possible to treat juxta-renal aaa's with endovascular techniques but that does not mean that one should. Pitfalls include loss of renal artery(s), mesenteric artery, and failure to exclude aneurysm resulting in a (now) harder open repair.I would be happy to review the images. Depending on health factors, open repair may be better --for one, you'll not need a ct scan again!

A palmaz stent: Stents and endovascular techniques are available; check with your vascular surgeon or interventional radiologist.

Open conversion: A fenestrated graft is technically challenging but feasible in experienced hands, otherwise in this condition open conversion is an option.

This is tough: Need to see ct. Chimney data is 2 years at best. Open surgery might be still best option. New stent devices are coming, would consider having a center look over your ct scan. Open surgery if the body can handle it, is still long term best. 10.2 is very large, i would favor open surgery.