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Endovascular healing is inadequate for fixation of Dacron stent-grafts in human aortoiliac vessels

Malina, Martin LU ; Brunkwall, J; Ivancev, Krassi LU ; Jonsson, J; Malina, J and Lindblad, Bengt LU (2000) In European Journal of Vascular and Endovascular Surgery 19(1). p.5-11
Abstract
BACKGROUND: migration and kinking of stent-grafts can occur late after endovascular aneurysm repair. It is unknown if endovascular grafts incorporate enough to be permanently anchored. In this report, healing of aortic stent-grafts was assessed in humans. PATIENTS AND METHODS: we retrieved 23 Dacron stent-grafts from patients treated for an aortic aneurysm since 1993. Twelve stent-grafts were explanted at late conversion to open repair and 11 at autopsy. The deaths were unrelated to graft fixation. The median age of the patients was 74 years (IQR 55-84 years) and the grafts were explanted 9 months (1-31 months) after insertion. Microscopic slides were prepared by conventional techniques or by cutting and grinding arterial specimens... (More)
BACKGROUND: migration and kinking of stent-grafts can occur late after endovascular aneurysm repair. It is unknown if endovascular grafts incorporate enough to be permanently anchored. In this report, healing of aortic stent-grafts was assessed in humans. PATIENTS AND METHODS: we retrieved 23 Dacron stent-grafts from patients treated for an aortic aneurysm since 1993. Twelve stent-grafts were explanted at late conversion to open repair and 11 at autopsy. The deaths were unrelated to graft fixation. The median age of the patients was 74 years (IQR 55-84 years) and the grafts were explanted 9 months (1-31 months) after insertion. Microscopic slides were prepared by conventional techniques or by cutting and grinding arterial specimens embedded in plastic with the stent-grafts in situ. RESULTS: the stent-grafts detached readily from the native arteries at surgery or autopsy, except when the stents had hooks or barbs which engaged the vessel wall. A space filled with poorly organised blood components persisted between the graft and the aortic wall 2.5 years after implantation. No firm incorporation of the grafts was observed proximally in the aneurysm neck or distally in the iliac segment. A friable neo-intimal layer covered parts of the luminal aspect of the grafts. CONCLUSIONS: endovascular healing provides poor fixation of Dacron stent-grafts in humans. At present, fixation relies on the mechanical properties of the stent-grafts. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Endovascular graft, Aortic aneurysm repair, Stent-graft, Healing, Dacron, Migration
in
European Journal of Vascular and Endovascular Surgery
volume
19
issue
1
pages
5 - 11
publisher
Elsevier
external identifiers
  • pmid:10706828
  • scopus:0034093671
ISSN
1532-2165
DOI
10.1053/ejvs.1999.0867
language
English
LU publication?
yes
id
aa80097a-dc40-4470-8e4f-e5d7073c12c5 (old id 1116480)
date added to LUP
2008-07-01 13:38:35
date last changed
2017-08-06 04:32:58
@article{aa80097a-dc40-4470-8e4f-e5d7073c12c5,
  abstract     = {BACKGROUND: migration and kinking of stent-grafts can occur late after endovascular aneurysm repair. It is unknown if endovascular grafts incorporate enough to be permanently anchored. In this report, healing of aortic stent-grafts was assessed in humans. PATIENTS AND METHODS: we retrieved 23 Dacron stent-grafts from patients treated for an aortic aneurysm since 1993. Twelve stent-grafts were explanted at late conversion to open repair and 11 at autopsy. The deaths were unrelated to graft fixation. The median age of the patients was 74 years (IQR 55-84 years) and the grafts were explanted 9 months (1-31 months) after insertion. Microscopic slides were prepared by conventional techniques or by cutting and grinding arterial specimens embedded in plastic with the stent-grafts in situ. RESULTS: the stent-grafts detached readily from the native arteries at surgery or autopsy, except when the stents had hooks or barbs which engaged the vessel wall. A space filled with poorly organised blood components persisted between the graft and the aortic wall 2.5 years after implantation. No firm incorporation of the grafts was observed proximally in the aneurysm neck or distally in the iliac segment. A friable neo-intimal layer covered parts of the luminal aspect of the grafts. CONCLUSIONS: endovascular healing provides poor fixation of Dacron stent-grafts in humans. At present, fixation relies on the mechanical properties of the stent-grafts.},
  author       = {Malina, Martin and Brunkwall, J and Ivancev, Krassi and Jonsson, J and Malina, J and Lindblad, Bengt},
  issn         = {1532-2165},
  keyword      = {Endovascular graft,Aortic aneurysm repair,Stent-graft,Healing,Dacron,Migration},
  language     = {eng},
  number       = {1},
  pages        = {5--11},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Endovascular healing is inadequate for fixation of Dacron stent-grafts in human aortoiliac vessels},
  url          = {http://dx.doi.org/10.1053/ejvs.1999.0867},
  volume       = {19},
  year         = {2000},
}