title: Deployment and healing of an ePTFE encapsulated stent endograft in the canine aorta.
abstract: This study evaluated deployment mechanics and long-term healing of an endoluminally placed stent/graft in normal canine aortas. The endoluminal graft (ELG) consisted of a 8.5 cm segment of expanded polytetrafluoroethylene (ePTFE) graft material (Impra, Inc., Tempe, AZ) encapsulating a series of six Palmaz P-128 stents (Johnson & Johnson Interventional Incorporated, New Brunswick, NJ) along the length of the graft. The prostheses were deployed via the femoral artery using a 14Fr delivery system that contained a balloon catheter to expand the ELG in the infrarenal aorta. Twenty-one prostheses were deployed and evaluated at 1 week (n = 3), 1 month (n = 3), 3 months (n = 3), 6 months (n = 9), and 1 year (n = 3). Dimensions of the infrarenal aorta were determined with intravascular ultrasound (IVUS) and angiography prior to deployment of devices. Real-time fluoroscopy and IVUS were used to monitor device deployment with both imaging modalities repeated following implantation. Gross inspection and microscopic evaluation was performed on the explanted specimens following in vivo evaluation by CT scan, IVUS, and angiography prior to retrieval of the specimens. The prostheses were easily deployed from the femoral access site. Oversizing of the deployment balloon compared to the aortic diameter was necessary to accommodate the 10% device recoil observed following balloon deflation, however, all devices were seated against the aortic wall as evidenced by IVUS. At explant, all devices ware widely patent with limited luminal thrombosis observed in four specimens (19%). Devices were well-incorporated by cellular ingrowth into the ePTFE with the formation of neointima. No device migration or postdeployment recoil was observed. ePTFE graft material between stents protruded slightly into the vessel lumen accounting for a 10% luminal reduction. Fully supported ELG's consisting of balloon expandable stents encapsulated in ePTFE are easily deployed using a low-profile delivery system. Specimens demonstrated uniform long-term patency and healing up to 1 year in a canine aortic model. Those preliminary findings support further study of this fully supported prosthesis in the treatment of arterial disease.
authors.affiliation: St. John's Cardiovascular Research Center, Harbor-UCLA Medical Center, Torrance 90509, USA.
authors.forename: E P
authors.initials: EP
authors.lastname: Wilson
authors.forename: R A
authors.initials: RA
authors.lastname: White
authors.forename: G E
authors.initials: GE
authors.lastname: Kopchok
authors.forename: C E
authors.initials: CE
authors.lastname: Donayre
authors.forename: C
authors.initials: C
authors.lastname: de Virgilio
authors.forename: J H
authors.initials: JH
authors.lastname: Geselschap
authors.forename: M
authors.initials: M
authors.lastname: Heilbron
mesh_terms: D000800:Angioplasty, Balloon; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001672:Biocompatible Materials; D001807:Blood Vessel Prosthesis; D004285:Dogs; D004867:Equipment Design; D006083:Graft Occlusion, Vascular / Q000175:diagnosis; D011138:Polytetrafluoroethylene; D015607:Stents; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D014654:Vascular Patency; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene