title: Assessment of a new type I endoleak repair technique using an anchoring device.
abstract: OBJECTIVE
  Type I endoleaks are one of the most frequent and life-threatening complications of thoracic endovascular aortic repair. This study aimed to assess the use of suture-anchoring devices for repairing type I endoleaks.
  
  
  METHODS
  The descending aortic aneurysm model (saccular type) was made by side-to-end anastomosis to a Dacron graft. A Matsui-Kitamura stent graft was deployed to create a proximal type I endoleak. Approximately 5 mm above the upper rim of the anastomosis, the aorta was punctured by the pistol of the suture-anchoring device with a T-shaped bar under fluoroscopy. Sutures were applied until angiography showed the absence of a type I endoleak. During the process, two pressure measurements were used to perform continuous assessments of aortic pressure and intra-aneurysm sac pressure.
  
  
  RESULTS
  A mean ± SD of 5 ± 1 anchoring shots were used to eliminate type I endoleaks. The device performed well, and no complications were observed. The mean ± SD intrasac pressures before stent graft deployment, during endoleak maintenance, and after repair were 118 ± 5, 61 ± 4, and 26 ± 5 mm Hg, respectively. The postrepair pressure was significantly decreased (P < 0.001; Student t test).
  
  
  CONCLUSIONS
  Despite some anatomic and clinical limitations identified during the experiments, the effectiveness of the suture-anchoring device was confirmed. Further improvement of the device will soon lead to its use as a less invasive endoleak repair procedure.
authors.affiliation: From the Department of General and Cardiothoracic Surgery, Kanazawa University, Kanazawa, Japan.
authors.forename: Pham Minh
authors.initials: PM
authors.lastname: Tuan
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohtake
authors.forename: Seguchi
authors.initials: S
authors.lastname: Ryuta
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000818:Animals; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D004195:Disease Models, Animal; D057867:Endoleak / Q000000981:diagnostic imaging / Q000601:surgery*; D004869:Equipment Safety; D011859:Radiography; D011897:Random Allocation; D034421:Sus scrofa; D053441:Suture Anchors; D013552:Swine; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods