A self-expanding bifurcated endovascular graft for abdominal aortic aneurysm repair. An initial study in a canine model.
Approximately 50,000 abdominal aortic aneurysms (AAAs) are surgically repaired annually in the United States. Endovascular grafts (EVGs) combine a stent and a vascular graft offering great potential for reduced morbidity, mortality, and hospital stay because of minimally invasive endoluminal placement through catheters. Because most AAAs extend into one or both iliac arteries, a bifurcated EVG (bEVG) was developed, consisting of a proximal aortic trunk divided into two distinct lumens or sockets to receive two smaller diameter leg (iliac) components. All components were composed of Didcott self-expanding braided wire stents integrally attached to porous spun polycarbonate urethane liners. Successful placement of the bEVGs (trunks 10-12 mm and legs 5-6 mm diameter) by a 10 Fr introducer through the femoral arteries into the infrarenal aorta and external iliac arteries of 9 of 11 dogs was achieved. Subsequently, 11 of 12 bEVGs were successfully placed to exclude a saccular aneurysm exceeding three aortic diameters created by a fascia lata pouch extending from the aorta into the left external iliac artery, of which 7 were patent at 1 to 4 months. These findings establish design feasibility of the bEVG as well as the utility of the canine experimental model.
Wilson
G J
GJ
Department of Pathology, Toronto Hospital (General Division), Ontario, Canada.
Klement
P
P
Kato
Y P
YP
Martin
J B
JB
Khan
I J
IJ
Alcime
R
R
Dereume
J P
JP
MacGregor
D C
DC
Pinchuk
L
L
D000818:Animals; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D004195:Disease Models, Animal; D004285:Dogs; D005069:Evaluation Studies as Topic; D006801:Humans; D007083:Iliac Artery / Q000601:surgery; D011474:Prosthesis Design; D011859:Radiography; D013997:Time Factors