Endoluminal repair of aneurysms containing ostia of essential branch arteries: an experimental model.
OBJECTIVE
To examine experimentally the feasibility of transfemoral endoluminal repair of aneurysms containing the ostia of essential branch arteries.


METHODS
In a canine model (n = 4), suprarenal aortic aneurysms were created by suturing an artificial patch onto an anterior arteriotomy. Following a 2-week recovery period, the dogs underwent endovascular exclusion of their aneurysms using an aortic stent-graft with separate renal artery branch grafts. Outcome was evaluated using angiography, intravascular ultrasound (IVUS), Doppler flow, invasive pressure monitoring, and autopsy, respectively.


RESULTS
Successful creation and subsequent endovascular exclusion of the aneurysm using aortic stent-grafts and separate bilateral renal artery stent-grafts was achieved in all trials. Angiographically, all aneurysms were excluded from aortic flow and all renal arteries were patent at completion of the procedure. With IVUS, good graft apposition and absence of perigraft flow were demonstrated in all animals. Mean pressure in the aneurysmal sac at completion of the procedure was 40 +/- 7 mmHg, compared to a mean systemic blood pressure of 105 +/- 8 mmHg (p < 0.05). At autopsy, no gross intimal damage was seen in the aorta or the renal arteries, and intact aortic grafts and branch grafts without twisting, coiling, or kinking were found in all trials.


CONCLUSIONS
In an acute animal model, suprarenal aortic aneurysms can be excluded from the circulation with preservation of renal flow using an endoluminally placed aortic stent-graft with separate branch grafts.
Wisselink
W
W
Division of Vascular Surgery, State University of New York Health Science Center, Brooklyn, USA. w.wisselink@azvu.nl
Abruzzo
F M
FM
Shin
C K
CK
Ramirez
J R
JR
Rodino
W
W
Kirwin
J D
JD
Panetta
T F
TF
D000208:Acute Disease; D000792:Angiography; D000818:Animals; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004195:Disease Models, Animal; D004285:Dogs; D005500:Follow-Up Studies; D010865:Pilot Projects; D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D015607:Stents; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional
D011093:Polyethylene Terephthalates; D011138:Polytetrafluoroethylene