Aneurysm pulsatility after endovascular exclusion--an experimental study using human aortic aneurysms.
OBJECTIVE
To measure the pulsatility of human aneurysms before and after complete exclusion with an endograft.


METHODS
Five aortic aneurysms obtained during necropsy were submitted to pulsatile perfusion before and after implantation of a bifurcated endograft. The specimens were contained in a closed chamber filled with saline solution. A vertical tube attached to the chamber was used to measure volume dislocation in each systole. Mural thrombus was kept intact, and the space around the device was filled with human blood. After each experiment, the aneurysm was opened to check for the correct positioning and attachment of the device.


RESULTS
The level of the saline column oscillated during pulsation in each case, with respective amplitudes of 17, 16, 13, 7, and 25 cm before the endograft insertion. After the insertion, the amplitudes dropped to 13, 12, 9, 3.5, and 23 cm, respectively. The differences were not significant. During the post-experimental examination, all devices were found to be in position and well attached to the neck and iliacs. No endoleak was detected during perfusion or by visual inspection.


CONCLUSIONS
Pulsation of an endograft is transmitted to the aneurysm wall even in the absence of endoleak, and should not be interpreted as procedural failure.
Orra
Hussein Amin
HA
Cirurgia Vascular e Endovascular, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Puech-Leão
Pedro
P
Silva
Erasmo Simão da
ES
Silva
Domingos Guerino
DG
D017544:Aortic Aneurysm, Abdominal / Q000503:physiopathology* / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002102:Cadaver; D006801:Humans; D011673:Pulsatile Flow / Q000502:physiology*