title: A self-expanding bifurcated endovascular graft for abdominal aortic aneurysm repair. An initial study in a canine model.
abstract: 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.
authors.affiliation: Department of Pathology, Toronto Hospital (General Division), Ontario, Canada.
authors.forename: G J
authors.initials: GJ
authors.lastname: Wilson
authors.forename: P
authors.initials: P
authors.lastname: Klement
authors.forename: Y P
authors.initials: YP
authors.lastname: Kato
authors.forename: J B
authors.initials: JB
authors.lastname: Martin
authors.forename: I J
authors.initials: IJ
authors.lastname: Khan
authors.forename: R
authors.initials: R
authors.lastname: Alcime
authors.forename: J P
authors.initials: JP
authors.lastname: Dereume
authors.forename: D C
authors.initials: DC
authors.lastname: MacGregor
authors.forename: L
authors.initials: L
authors.lastname: Pinchuk
mesh_terms: 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