title: Geometric study of various chimney graft configurations in an in vitro juxtarenal aneurysm model.
abstract: OBJECTIVE
  To determine gutter size and stent-graft geometry in an in vitro juxtarenal aneurysm model using various chimney graft (CG) configurations.
  
  
  METHODS
  Two silicone juxtarenal aortic aneurysm models were constructed combining different diameters of the aorta and renal artery. In a single-branched CG configuration, 2 sizes (23 and 28.5 mm) of Excluder stent-grafts were tested individually with 2 sizes of 2 types of CGs: Advanta balloon-expandable (BE) stent-grafts (6×59 and 12×61 mm) and Viabahn self-expanding (SE) stent-grafts (6×50 and 13×50 mm). All combinations were tested with a short (10-mm) and long (20-mm) sealing zone between the CG and main graft (total 16 configurations). Immediately after deployment, the CG configuration was scanned using a 64-slice computed tomography scanner. Gutter sizes were measured at different levels of the sealing zone.
  
  
  RESULTS
  At the top of the sealing zone, the gutters were significantly larger in the BE CGs compared to SE CGs in combination with the 23-mm main graft (p=0.021). At the bottom of the sealing zone, there were no statistically significant differences (p=0.77). No significant differences were seen using the 28.5-mm main graft. Median gutter size was larger in the 6-mm CGs. The length of the sealing zone had no influence on gutter size. Significant compression of the main graft was found using 12 or 13-mm CGs compared to 6-mm CGs (p=0.001).
  
  
  CONCLUSIONS
  In this in vitro study, the CG configurations with BE stent-grafts show larger gutters than configurations with SE stent-grafts in small main grafts. Main graft compression is increased using wider CG stent-grafts.
authors.affiliation: Department of Vascular Surgery, VU University Medical Center, Amsterdam, The Netherlands. jorgldebruin@gmail.com
authors.forename: Jorg L
authors.initials: JL
authors.lastname: de Bruin
authors.forename: Kak K
authors.initials: KK
authors.lastname: Yeung
authors.forename: Wouter W
authors.initials: WW
authors.lastname: Niepoth
authors.forename: Rutger J
authors.initials: RJ
authors.lastname: Lely
authors.forename: Qingfeng
authors.initials: Q
authors.lastname: Cheung
authors.forename: Anesh
authors.initials: A
authors.lastname: de Vries
authors.forename: Jan D
authors.initials: JD
authors.lastname: Blankensteijn
mesh_terms: D000818:Animals; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D008422:Materials Testing; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D011474:Prosthesis Design; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012828:Silicones; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D012828:Silicones