title: A novel pressure difference-induced perforation aortic stent-grafts system: an experimental study.
abstract: BACKGROUND
  Most of endovascular stent-graft modifications to preserve side branch must be customized according to extensive pre-operative assessment, which may not be possible in many hospitals and emergency settings. The study was to develop a novel stent-grafts system that would allow in situ "fenestration", with less reliance on preoperative imaging.
  
  
  METHODS
  The magnitude of pressure difference (PD) between left subclavian artery (LSA) and aortic arch were measured in 12 experimental pigs. Changes of PD before and after LSA was covered were analyzed respectively. The novel stent graft was made by multi-dimensional and multiple textiles forming technology. According to the PD measurement in pigs, we evaluated the feasibility of the stent-graft in a mock circulation system.
  
  
  RESULTS
  In pigs, the blood pressure of aortic arch was significantly higher than that of LSA after it was covered (P < 0.001) and PD was (42.78 ± 5.17) mmHg. After target vessel was covered and when PD between the LSA and aorta reached the magnitude measured in pigs, contrast media oozed from the cranny of graft to the LSA, which was generated by sliding and deformation of yarns of novel stent-graft.
  
  
  CONCLUSIONS
  The study proposes the design of pressure difference-induced perforation aortic stent-grafts system and verifies that the PD between LSA and aortic arch is high enough to allow in situ "fenestration" by stent graft made by multi-dimensional and multiple textiles forming technology.
authors.affiliation: Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
authors.forename: Guo-Yu
authors.initials: GY
authors.lastname: Deng
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Qing-Sheng
authors.initials: QS
authors.lastname: Lu
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Le-Wei
authors.initials: LW
authors.lastname: Hou
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
authors.forename: Jian-Nan
authors.initials: JN
authors.lastname: Wang
authors.forename: Shu-Ming
authors.initials: SM
authors.lastname: Zhang
authors.forename: Zhi-Qing
authors.initials: ZQ
authors.lastname: Zhao
authors.forename: Zai-Ping
authors.initials: ZP
authors.lastname: Jing
mesh_terms: D000818:Animals; D001013:Aorta, Thoracic / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D011474:Prosthesis Design; D013348:Subclavian Artery; D013552:Swine