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Endovascular stent-anchored aortic grafts: a comparison between self-expanding and balloon-expandable stents in minipigs

Lindh, Mats LU ; Malina, Martin LU ; Ivancev, K; Brunkwall, J and Lindblad, Bengt LU (1996) In Journal of Endovascular Surgery 3(3). p.284-289
Abstract
PURPOSE: To study endovascular graft attachment with self-expanding Gianturco Z-stents and balloon-expanded Palmaz stents and the effect of these devices on the renal ostia. METHODS: Ten stent-grafts were constructed, 5 with Gianturco Z-stents and 5 with Palmaz stents. The endografts were implanted under fluoroscopic guidance into the abdominal aorta of 10 pigs so that the uncovered portion of the proximal stent extended over the renal artery orifices. Distal aortic blood pressure and flow were measured before and after graft placement and 1 hour postprocedure. The aorta was then exposed surgically, and the central portion of the stent-graft was inspected through an aortotomy to assess perigraft leakage. RESULTS: Stent-graft implantation... (More)
PURPOSE: To study endovascular graft attachment with self-expanding Gianturco Z-stents and balloon-expanded Palmaz stents and the effect of these devices on the renal ostia. METHODS: Ten stent-grafts were constructed, 5 with Gianturco Z-stents and 5 with Palmaz stents. The endografts were implanted under fluoroscopic guidance into the abdominal aorta of 10 pigs so that the uncovered portion of the proximal stent extended over the renal artery orifices. Distal aortic blood pressure and flow were measured before and after graft placement and 1 hour postprocedure. The aorta was then exposed surgically, and the central portion of the stent-graft was inspected through an aortotomy to assess perigraft leakage. RESULTS: Stent-graft implantation was accurate and hemostatic in all cases, despite longitudinal folding of the graft due to oversizing. However, transverse folds produced pressure gradients (> 15 mmHg) between the ends of the graft in two cases. In another case, a pressure gradient resulted from partial thrombosis of the graft. In two cases, renal artery occlusion and thrombosis occurred due to coverage by the graft material. In two other animals, one of the renal arteries was entirely uncovered by a stent. The remaining 16 renal arteries were covered by the proximal stent but not the graft, as intended. One (6.25%) of these arteries thrombosed, but the remainder were grossly patent when the animals were sacrificed at 1 hour. CONCLUSIONS: Both Palmaz and Gianturco Z-stents produced hemostatic endovascular graft attachment, even in the presence of moderate graft oversizing. The risk of acute renal artery occlusion from juxtarenal stenting does not appear to be prohibitive, but longer term observations are needed. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
endoprostheses, stent-graft, stents, endoluminal graft, experimental study
in
Journal of Endovascular Surgery
volume
3
issue
3
pages
284 - 289
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:8800231
  • scopus:0029786736
ISSN
1074-6218
DOI
10.1583/1074-6218(1996)003<0284:ESAAGA>2.0.CO;2
language
English
LU publication?
yes
id
8a2d2133-67cb-49de-922b-52781c7b3b44 (old id 1109994)
date added to LUP
2008-07-25 16:06:30
date last changed
2017-01-01 07:01:06
@article{8a2d2133-67cb-49de-922b-52781c7b3b44,
  abstract     = {PURPOSE: To study endovascular graft attachment with self-expanding Gianturco Z-stents and balloon-expanded Palmaz stents and the effect of these devices on the renal ostia. METHODS: Ten stent-grafts were constructed, 5 with Gianturco Z-stents and 5 with Palmaz stents. The endografts were implanted under fluoroscopic guidance into the abdominal aorta of 10 pigs so that the uncovered portion of the proximal stent extended over the renal artery orifices. Distal aortic blood pressure and flow were measured before and after graft placement and 1 hour postprocedure. The aorta was then exposed surgically, and the central portion of the stent-graft was inspected through an aortotomy to assess perigraft leakage. RESULTS: Stent-graft implantation was accurate and hemostatic in all cases, despite longitudinal folding of the graft due to oversizing. However, transverse folds produced pressure gradients (&gt; 15 mmHg) between the ends of the graft in two cases. In another case, a pressure gradient resulted from partial thrombosis of the graft. In two cases, renal artery occlusion and thrombosis occurred due to coverage by the graft material. In two other animals, one of the renal arteries was entirely uncovered by a stent. The remaining 16 renal arteries were covered by the proximal stent but not the graft, as intended. One (6.25%) of these arteries thrombosed, but the remainder were grossly patent when the animals were sacrificed at 1 hour. CONCLUSIONS: Both Palmaz and Gianturco Z-stents produced hemostatic endovascular graft attachment, even in the presence of moderate graft oversizing. The risk of acute renal artery occlusion from juxtarenal stenting does not appear to be prohibitive, but longer term observations are needed.},
  author       = {Lindh, Mats and Malina, Martin and Ivancev, K and Brunkwall, J and Lindblad, Bengt},
  issn         = {1074-6218},
  keyword      = {endoprostheses,stent-graft,stents,endoluminal graft,experimental study},
  language     = {eng},
  number       = {3},
  pages        = {284--289},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Surgery},
  title        = {Endovascular stent-anchored aortic grafts: a comparison between self-expanding and balloon-expandable stents in minipigs},
  url          = {http://dx.doi.org/10.1583/1074-6218(1996)003<0284:ESAAGA>2.0.CO;2},
  volume       = {3},
  year         = {1996},
}