Prevention of spinal cord ischemia in an ovine model of abdominal aortic aneurysm treated with a self-expanding stent-graft.
OBJECTIVE
To present novel techniques to prevent spinal ischemia during aneurysm creation and chronic bifurcated stent-graft implantation in an ovine model of abdominal aortic aneurysm (AAA).


METHODS
Experimental AAAs were created in 38 sheep. To prevent spinal ischemia, an internal aortic shunt was used during aneurysm creation. In the animals designated to receive bifurcated stent-grafts, a left external iliac-to-internal iliac bypass was performed to revascularize the caudal artery and prevent postdeployment spinal cord ischemia. Specimens were harvested at 1 week, 1, 3, and 6 months, and 1 year.


RESULTS
Aneurysms were successfully created without paralysis in 35 animals. Two died due to aspiration pneumonia. Of the 33 animals implanted with endografts, 16 (94%) of 17 with straight devices and 15 (94%) of 16 with bifurcated stent-grafts survived with well-functioning, patent stent-grafts. Paralysis developed in 2 animals after endografting due to technical failures.


CONCLUSIONS
The use of an internal shunt during aneurysm creation and internal iliac-to-external iliac transposition prior to bifurcated stent-graft deployment prevented spinal ischemia in an ovine AAA model. Chronically deployed stent-grafts were well tolerated.
Beygui
R E
RE
Division of Vascular Surgery, Stanford University School of Medicine, California, USA.
Kinney
E V
EV
Pelc
L R
LR
Krievins
D
D
Whittemore
J
J
Fogarty
T J
TJ
Zarins
C K
CK
D000714:Anastomosis, Surgical; D000792:Angiography; D017546:Angioscopy; D000818:Animals; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001672:Biocompatible Materials; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D004195:Disease Models, Animal; D005260:Female; D007083:Iliac Artery / Q000601:surgery; D011093:Polyethylene Terephthalates; D012756:Sheep; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D001672:Biocompatible Materials; D011093:Polyethylene Terephthalates