Sealing of type III endoleaks with ethylene vinyl alcohol copolymer in a canine model.
OBJECTIVE
To test ethylene vinyl alcohol copolymer (EVOH) as a sealing agent for persistent abdominal aortic aneurysm (AAA) endograft leaks.


METHODS
Twelve dogs underwent creation of AAAs with a Palmaz P4014 stent. A 10-mm x 5-cm Wallgraft endoprosthesis with a 4-mm-diameter hole cut into its side was deployed within the AAA. One week later, computed tomography (CT) and angiography were performed and the aneurysm sac was catheterized through the 4-mm hole. Then, EVOH was injected into the sac and lumbar arteries. Four weeks thereafter, all surviving animals underwent repeat CT scanning and angiography and were then euthanized. The AAA underwent gross and microscopic study.


RESULTS
Three dogs died from aortic rupture within 24 hours of AAA creation and the remaining nine dogs survived to receive EVOH. All nine dogs had persistent flow into the sac and lumbar arteries at the time of EVOH delivery. Seven dogs survived to the end of the experiment, and all aneurysm sacs and lumbar arteries remained occluded on angiography and CT. Histologic examination revealed EVOH and thrombus admixed, with thrombus in varying stages of organization filling the aneurysm sac and lumbar arteries.


CONCLUSIONS
Embolization of type III endoleaks with EVOH proved to be feasible in a canine model. Further work is warranted to determine its therapeutic utility.
Maffra
Romualdo
R
Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
Anene
Alvin U
AU
Sands
Mark
M
Dong
Yong-Hua
YH
Davros
William
W
Brennecke
Lucas H
LH
Dolmatch
Bart L
BL
D000818:Animals; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D004195:Disease Models, Animal; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D008297:Male; D011145:Polyvinyls / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer