title: In Vitro Evaluation of Upstream and Downstream Influences on Blood Pressure of the Hybrid Treatment of Thoracoabdominal Aortic Aneurysms.
abstract: BACKGROUND
  The aim of our study was to assess, by means of an experimental model, whether different geometries in retrograde bypass and stent-graft deployment may affect upstream and downstream blood pressure in hybrid treatment.
  
  
  METHODS
  An in vitro model of the arterial circulation has been prepared, which consists of a peristaltic pump, silicon tubes with geometrical and mechanical properties close to realistic arteries, a terminal reservoir kept at constant pressure, and a sequence of pressure transducers. The system allows us to study the pressure wave propagation in physiological conditions and simulate the patient's conditions as a result of debranching in 2 different configurations.
  
  
  RESULTS
  In configuration 1, the mean pressure value (Kpa) was 4.72 in silicone tube before stent graft and debranching, 4.59 in visceral and renal bypass, and 4.38 in silicone tube after stent graft and debranching. In configuration 2, the mean pressure value (Kpa) was 5.22 in silicone tube before stent graft and debranching, 4.48 in visceral and renal bypass, and 4.99 in silicone tube after stent graft and debranching.
  
  
  CONCLUSIONS
  The experimental data suggest that the debranching geometry and the material of the grafts and stent grafts change significantly the physiological arterial pressure possibly leading to an augmented pressure upstream of the stent grafts, owing to retrograde pressure waves toward the heart, and a decreased pressure downstream visceral and renal arteries.
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy. Electronic address: giovanni.spinella@unige.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Spinella
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Bianca
authors.initials: B
authors.lastname: Pane
authors.affiliation: Department of Civil, Environmental and Architectural Engineering, University of Genova, Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonfiglio
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Debora
authors.initials: D
authors.lastname: Musio
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Perfumo
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Gazzola
authors.affiliation: Department of Civil, Environmental and Architectural Engineering, University of Genova, Genova, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stocchino
authors.affiliation: Vascular and Endovascular Surgery Unit, University Hospital IRCCS San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Palombo
mesh_terms: D001013:Aorta, Thoracic / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000503:physiopathology / Q000601:surgery*; D062186:Arterial Pressure; D001783:Blood Flow Velocity; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D002445:Celiac Artery / Q000503:physiopathology / Q000601:surgery; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000503:physiopathology / Q000601:surgery; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D011474:Prosthesis Design; D012039:Regional Blood Flow; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery; D015607:Stents; D013997:Time Factors