Chronic intraaneurysmal pressure measurement: an experimental method for evaluating the effectiveness of endovascular aortic aneurysm exclusion.
OBJECTIVE
To evaluate and compare the intraaneurysmal pressure (IAP) after exclusion using two different endovascular grafts.


METHODS
Eight mongrel dogs had a 3 x 3 cm polytetrafluoroethylene (PTFE) aneurysm sewn as an interposition graft of the infrarenal aorta. A pressure transducer implanted into the aneurysm wall permitted continuous electronic IAP monitoring. Four aneurysms were excluded with a transluminally placed endovascular graft made of a PTFE graft and two Palmaz stents (PTFE-EG), three were excluded with a tantalum-Dacron endovascular graft (TD-EG), and one was surgically treated with a standard PTFE graft (PTFE-Surg). The dogs were observed for 18 to 50 days (mean, 37.5 days) and were evaluated after surgery with duplex and spiral computed tomographic scans.


RESULTS
All grafts successfully excluded the aneurysms without perigraft channels or leaks as documented by arteriogram and duplex and computed tomographic scans. The mean IAPs after repair with all PTFE-EGs were significantly lower (p < 0.001) than the mean systemic pressures. In addition, the mean IAP reduction was significantly greater (p < 0.005) in the PTFE-EG group than in the TD-EG group.


CONCLUSIONS
Aneurysm exclusion with PTFE-EG significantly lowered IAP, did so significantly better than the TD-EG, and approached the IAP reduction obtained by standard repair. Such pressure reduction is necessary for effective protection against aneurysm rupture.
Sanchez
L A
LA
Department of Surgery, Montefiore Medical Center, University Hospital for the Albert Einstein College of Medicine, New York, NY, USA.
Faries
P L
PL
Marin
M L
ML
Ohki
T
T
Parsons
R E
RE
Marty
B
B
Soeiro
D
D
Olivieri
S
S
Veith
F J
FJ
D000818:Animals; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001795:Blood Pressure Determination / Q000295:instrumentation / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000379:methods*; D004195:Disease Models, Animal; D004285:Dogs; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D013635:Tantalum; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
D011093:Polyethylene Terephthalates; D013635:Tantalum; D011138:Polytetrafluoroethylene