Suitability of incorporated vascular stents for surgical patch-plasty: an experimental study.
OBJECTIVE
Evaluate the feasibility of expanding arterial and venous stents incorporated into the vessel wall by surgical patch-plasty in an experimental study.


METHODS
An 8-mm Wallstent was percutaneously implanted into the carotid artery of 11 sheep and into the ipsilateral jugular vein in three of them. Three months after implantation, a patch-plasty was performed on the incorporated stents using a 0.4-mm-thick synthetic patch made of polytetrafluoroethylene (PTFE). Stent patency was monitored by color-coded duplex ultrasound and angiography for 6 months after operation.


RESULTS
No suture dehiscence or aneurysm formation were observed. Nine of 11 arterial and 2 of 3 venous stents remained fully patent during follow-up. In arteries, complications encountered were a complete stent thrombosis early after surgery, as well as a floating thrombus in the stent, found at final angiography after 6 months. In veins, one partial stent thrombosis was observed. Microradiographic and histological examinations revealed marked intimal hyperplasia in both arterial and venous stents. Intimal hyperplasia was significantly more pronounced in patched than in stented arterial segments (p < 0.005).


CONCLUSIONS
Patch-plasty surgery of previously incorporated vascular stents is technically feasible. Mid-term patency rates were acceptable.
Schürmann
K
K
Department of Diagnostic Radiology, University of Technology, Aachen, Germany.
Vorwerk
D
D
Rosenbaum
C
C
Eckert
K
K
Biesterfeld
S
S
Stopinski
T
T
Günther
R W
RW
D000783:Aneurysm / Q000209:etiology; D000792:Angiography; D000818:Animals; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006965:Hyperplasia; D007601:Jugular Veins / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008422:Materials Testing; D008852:Microradiography; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants / Q000009:adverse effects; D012756:Sheep; D015607:Stents / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013536:Suture Techniques / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D017539:Tunica Intima / Q000473:pathology; D018615:Ultrasonography, Doppler, Color; D014654:Vascular Patency
D011138:Polytetrafluoroethylene