Endovascular graft placement in experimental dissection of the thoracic aorta.
OBJECTIVE
To test the effectiveness of endoluminal exclusion of the false lumen in experimental thoracic aortic dissection by occlusion of the entry site with a balloon-expandable endograft.


METHODS
Thoracic aortic dissections were induced surgically in six beagles. The endograft consisted of an ultrathin, 12-mm-wide polyester tube sutured over a Strecker stent that was already crimped onto an angioplasty balloon. Fluoroscopic and intravascular ultrasonographic (IVUS) guidance were used. Endografts were introduced by means of femoral arteriotomy, via a 12-F sheath positioned in the aorta, and were then expanded on the angioplasty catheter.


RESULTS
IVUS and aortography showed an extensive thoracic dissection in all animals. Only four of six endografts were successfully placed. At 1 month, all thoracic endografts were patent, but the false lumen was never thrombosed. IVUS scans demonstrated a malpositioned endograft in two cases and persistent reentry in all cases.


CONCLUSIONS
Endovascular grafting of the aorta was feasible in experimental thoracic aortic dissection, but thrombosis of the false lumen was not achieved.
Boudghène
F
F
Department of Radiology, Hopital Tenon, Paris, France.
Sapoval
M
M
Bigot
J M
JM
Michel
J B
JB
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D000818:Animals; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004285:Dogs; D015607:Stents; D018084:Ultrasonography, Interventional