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Open repair is effective but carries substantial morbidity, especially in high-risk patients. Methods: From 2019–2025, 9 MAS patients with branch-vessel disease underwent endovascular repair using the Chimney technique, guided by computed tomography angiography. Feasibility, safety, hemodynamic changes, renal function, and target-vessel stent patency were assessed. Results: Technical success and target-vessel patency were 100%, with no deaths, renal impairment, or 30-day mortality; durable outcomes followed over a median 3-year follow-up.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/feasibility-and-early-and-midterm-outcomes-of-midaortic-syndrome-a-retrospective-cohort-study/461603/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/feasibility-and-early-and-midterm-outcomes-of-midaortic-syndrome-a-retrospective-cohort-study/461603.png","ImageObject",300,407,{"name":92,"@type":93},"nayy☆","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does this study address for patients with Midaortic Syndrome (MAS)?","Question",{"text":112,"@type":113},"MAS causes segmental narrowing of the aorta, often with renal or visceral ostial stenosis, leading to severe hypertension and potential end-organ dysfunction. 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Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of General and Specialized Surgery, College of Medicine, Taibah University, Medina 42353, Saudi Arabia; [hgedaiby@taibahu.edu.sa](hgedaiby@taibahu.edu.sa)  \n2 Department of Vascular and Endovascular Surgery, Brüderklinikum Julia Lanz Hospital,  \n68165 Mannheim, Germany; [mmf9474@yahoo.de](mmf9474@yahoo.de)  \n* Correspondence: m.keese@bbtgruppe.de  \n† These authors contributed equally to this work.  \nAbstract  \nBackground: Midaortic Syndrome (MAS) is a rare vascular condition characterized by segmental narrowing of the thoracic and abdominal aorta, often involving ostial narrowing of the renal or visceral arteries. While open surgical repair has been the standard treatment, it carries significant morbidity, especially in high-risk patients. Endovascular techniques, including the Chimney approach, provide a minimally invasive alternative topreserve and reestablish both aortic and branch vessel perfusion. This study evaluates the feasibility, safety, and early and midterm outcomes of the Chimney technique used in a cohort of patients with MAS. Methods: Between 2019 and 2025, 9 patients with MAS and branch vessel involvement underwent endovascular repair using the Chimney technique at Brüderklinikum Julia Lanz Hospital in the Mannheim Teaching Hospital of Heidelberg University. Pre-procedural planning was based on computed tomography angiography. Technical success, peri-procedural complications, changes in blood pressure, renal function, and target-vessel stent patency were monitored. Patients were followed over a median of 3 years (range, 0.08–6 years) . Results: Nine patients (mean age 77.2 ± 8.7 years; 66.6% female) underwent endovascular repair for midaortic syndrome. All patients were unfit for open surgery. Comorbidities included hypertension (100%), coronary artery disease (100%), and chronic kidney disease (77.7%) . Technical success and target-vessel patency were 100%, with no intraoperative deaths, impairment of renal function, or 30-day mortality. One patient (11.1%) developed an access-site hematoma, which was managed conservatively. Median hospital stay was 6 days. During a median 3-year follow-up (range 1 month– 6 years), all chimney stents remained patent, patients experienced durable symptom relief, blood pressure improvement, and freedom from reintervention. Conclusions: The Chimney technique offers a safe and effective endovascular option for high-risk patients with Midaortic Syndrome, achieving high technical success, preserved branch-vessel patency, and improvement of symptoms. Larger studies with longer follow-up are warranted to confirm durability and optimize patient selection for this technique.  \nKeywords: Midaortic Syndrome; endovascular repair; chimney technique; renal artery; visceral artery; hypertension  \n1. Introduction  \nMidaortic Syndrome (MAS) is a rare vascular disorder characterized by segmental narrowing of the distal thoracic or abdominal aorta, often accompanied by ostial stenosis of  \nthe renal and visceral arteries. The condition was initially reported by Sen and colleagues in 1963 [1] . It typically affects younger individuals and manifests with severe hypertension, claudication, or end-organ dysfunction. MAS is a markedly uncommon vascular disorder, representing less than 1% of aortic coarctation cases and an estimated incidence of roughly 1 per million individuals [2–4] . In untreated patients, mortality rates may reach up to 90% by the sixth decade of ","cbCaid7otgneXb8L","https://ap.wps.com/l/cbCaid7otgneXb8L","pdf",2378556,12,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What problem does this study address for patients with Midaortic Syndrome (MAS)?\",\"answer\":\"MAS causes segmental narrowing of the aorta, often with renal or visceral ostial stenosis, leading to severe hypertension and potential end-organ dysfunction. The study focuses on evaluating feasibility, safety, and early-to-midterm outcomes of endovascular management in high-risk patients.\"},{\"question\":\"How were patients treated and how was planning performed?\",\"answer\":\"Nine MAS patients with branch-vessel involvement underwent endovascular repair using the Chimney technique between 2019 and 2025. Pre-procedural planning relied on computed tomography angiography, and outcomes were monitored peri-procedurally.\"},{\"question\":\"What were the main outcome results reported in the study?\",\"answer\":\"Technical success and target-vessel stent patency were reported as 100%. There were no intraoperative deaths or 30-day mortality, and follow-up showed stent patency, durable symptom relief, improved blood pressure, and freedom from reintervention.\"}]","Feasibility and Early and Midterm Outcomes of Midaortic Syndrome - A Retrospective Cohort Study | PDF",1790761951]