In vitro assessment of aortic stent-graft integrity following exposure to Onyx liquid embolic agent.
OBJECTIVE
Endovascular stent-grafts are increasingly being used for treatment of abdominal and thoracic aortic aneurysms. Postprocedural complications include development of endoleaks. Recently, an embolic agent known as Onyx has been employed to treat type II endoleaks. Onyx is a biocompatible copolymer dissolved in dimethyl sulfoxide (DMSO). Although DMSO is known to damage some angiographic catheters, little is known concerning whether this compound damages stent-graft material. The current study was undertaken to directly explore this issue.


METHODS
Four stent-grafts were evaluated: the Excluder, Zenith, AneuRx, and Talent. Stent-grafts were incubated for 24 hours at 37 degrees C under each of the following conditions: DMSO alone, 50/50 mixture of DMSO/Onyx, mixture of 1 part 50/50 DMSO/Onyx and 9 parts whole blood, and untreated control. Stent-grafts were microdissected into 15-mm sections, after which they were evaluated with scanning electron microscopy.


RESULTS
No appreciable differences between stent-grafts exposed to DMSO and untreated controls were seen. Although liquid embolic agent was seen coating stent-grafts exposed to a 50/50 mixture of DMSO and Onyx, no evidence of fiber breakdown was noted. Stent-grafts exposed to DMSO/Onyx/whole blood demonstrated a thin coating of clot and Onyx without visual evidence of fiber compromise.


CONCLUSIONS
The current study provides compelling evidence that short-term exposure of endograft material to DMSO, DMSO/Onyx, or DMSO/Onyx/whole blood is not associated with acute structural compromise of four commonly used aortic endografts. Future in vivo studies will help to further establish the safety of this agent.
Stone
James R
JR
Division of Interventional Radiology, Department of Radiology, University of Virginia, Charlottesville, VA 22908, USA.
Evans
Avery J
AJ
Angle
John F
JF
Arslan
Bulent
B
Turba
Ulku C
UC
Matsumoto
Alan H
AH
D001011:Aorta / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D004121:Dimethyl Sulfoxide / Q000737:chemistry*; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D011145:Polyvinyls / Q000737:chemistry*; D011183:Postoperative Complications / Q000517:prevention & control; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012997:Solvents / Q000737:chemistry; D015607:Stents; D013499:Surface Properties; D013696:Temperature; D013995:Time
C450660:Onyx copolymer; D011145:Polyvinyls; D012997:Solvents; D004121:Dimethyl Sulfoxide