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Endovascular AAA exclusion: will stents with hooks and barbs prevent stent-graft migration?

Malina, Martin LU ; Lindblad, Bengt LU ; Ivancev, Krassi LU ; Lindh, Mats LU ; Malina, Janne and Brunkwall, Jan (1998) In Journal of Endovascular Surgery 5(4). p.310-317
Abstract
PURPOSE: To investigate if stents with hooks and barbs will improve stent-graft fixation in the abdominal aorta. METHODS: Sixteen- to 24-mm-diameter Dacron grafts were deployed inside cadaveric aortas. The grafts were anchored by stents as in endovascular abdominal aortic aneurysm repair. One hundred thirty-seven stent-graft deployments were carried out with modified self-expanding Z-stents with (A) no hooks and barbs (n = 75), (B) 4 5-mm-long hooks and barbs (n = 39), (C) 8 10-mm-long, strengthened hooks and barbs (n = 19), or (D) hooks only (n = 4). Increasing longitudinal traction was applied to determine the displacement force needed to extract the stent-grafts. The radial force of the stents was measured and correlated to the... (More)
PURPOSE: To investigate if stents with hooks and barbs will improve stent-graft fixation in the abdominal aorta. METHODS: Sixteen- to 24-mm-diameter Dacron grafts were deployed inside cadaveric aortas. The grafts were anchored by stents as in endovascular abdominal aortic aneurysm repair. One hundred thirty-seven stent-graft deployments were carried out with modified self-expanding Z-stents with (A) no hooks and barbs (n = 75), (B) 4 5-mm-long hooks and barbs (n = 39), (C) 8 10-mm-long, strengthened hooks and barbs (n = 19), or (D) hooks only (n = 4). Increasing longitudinal traction was applied to determine the displacement force needed to extract the stent-grafts. The radial force of the stents was measured and correlated to the displacement force. RESULTS: The median (interquartile range) displacement force needed to extract grafts anchored by stent A was 2.5 N (2.0 to 3.4), stent B 7.8 N (7.4 to 10.8), and stent C 22.5 N (17.1 to 27.9), p < 0.001. Both hooks and barbs added anchoring strength. During traction, the weaker barbs were distorted or caused intimal tears. The stronger barbs engaged the entire aortic wall. The radial force of the stents had no impact on fixation, while aortic calcification and graft oversizing had marginal effects. CONCLUSIONS: Stent barbs and hooks increased the fixation of stent-grafts tenfold, while the radial force of stents had no impact. These data may prove important in future endograft development to prevent stent-graft migration after aneurysm exclusion. (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
endovascular grafting, abdominal aortic aneurysm, migration, Z-stents
in
Journal of Endovascular Surgery
volume
5
issue
4
pages
310 - 317
publisher
International Society of Endovascular Specialists
external identifiers
  • pmid:9867319
  • scopus:0031647079
ISSN
1074-6218
DOI
10.1583/1074-6218(1998)005<0310:EAEWSW>2.0.CO;2
language
English
LU publication?
yes
id
874ac099-68ec-4d7b-89a3-c661be8d0aba (old id 1112759)
date added to LUP
2008-07-11 09:56:16
date last changed
2017-08-06 04:26:34
@article{874ac099-68ec-4d7b-89a3-c661be8d0aba,
  abstract     = {PURPOSE: To investigate if stents with hooks and barbs will improve stent-graft fixation in the abdominal aorta. METHODS: Sixteen- to 24-mm-diameter Dacron grafts were deployed inside cadaveric aortas. The grafts were anchored by stents as in endovascular abdominal aortic aneurysm repair. One hundred thirty-seven stent-graft deployments were carried out with modified self-expanding Z-stents with (A) no hooks and barbs (n = 75), (B) 4 5-mm-long hooks and barbs (n = 39), (C) 8 10-mm-long, strengthened hooks and barbs (n = 19), or (D) hooks only (n = 4). Increasing longitudinal traction was applied to determine the displacement force needed to extract the stent-grafts. The radial force of the stents was measured and correlated to the displacement force. RESULTS: The median (interquartile range) displacement force needed to extract grafts anchored by stent A was 2.5 N (2.0 to 3.4), stent B 7.8 N (7.4 to 10.8), and stent C 22.5 N (17.1 to 27.9), p &lt; 0.001. Both hooks and barbs added anchoring strength. During traction, the weaker barbs were distorted or caused intimal tears. The stronger barbs engaged the entire aortic wall. The radial force of the stents had no impact on fixation, while aortic calcification and graft oversizing had marginal effects. CONCLUSIONS: Stent barbs and hooks increased the fixation of stent-grafts tenfold, while the radial force of stents had no impact. These data may prove important in future endograft development to prevent stent-graft migration after aneurysm exclusion.},
  author       = {Malina, Martin and Lindblad, Bengt and Ivancev, Krassi and Lindh, Mats and Malina, Janne and Brunkwall, Jan},
  issn         = {1074-6218},
  keyword      = {endovascular grafting,abdominal aortic aneurysm,migration,Z-stents},
  language     = {eng},
  number       = {4},
  pages        = {310--317},
  publisher    = {International Society of Endovascular Specialists},
  series       = {Journal of Endovascular Surgery},
  title        = {Endovascular AAA exclusion: will stents with hooks and barbs prevent stent-graft migration?},
  url          = {http://dx.doi.org/10.1583/1074-6218(1998)005<0310:EAEWSW>2.0.CO;2},
  volume       = {5},
  year         = {1998},
}