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Experimental Evaluation of Complete Endovascular Arch Reconstruction by In Situ Retrograde Fenestration
- Source :
- Annals of Thoracic Surgery, Annals of Thoracic Surgery, Elsevier, 2014, 98 (6), pp.2086-2090. ⟨10.1016/j.athoracsur.2014.07.024⟩
- Publication Year :
- 2014
- Publisher :
- Elsevier BV, 2014.
-
Abstract
- Background The aim of this experimental study was to assess the feasibility of complete endovascular arch reconstruction by in situ retrograde fenestration and to investigate the impact of stent-graft material on stent-graft fenestrations. Methods The experiments were performed using 8 cadaveric human thoracic aortas (aortic arch) using 2 different stent-graft types: woven polyester (Valiant Captivia; Medtronic Vascular, Santa Rosa, CA) and expanded polytetrafluoroethylene (conformable [C]-TAG; W.L. Gore & Associates, Flagstaff, AZ). A benchtop aortic pulsatile flow model was used. Stent-grafts were deployed into the aortic arch, covering the ostia of the supraaortic trunks. A 5-mm 30-degree angioscope was introduced into the ascending aorta to monitor the procedure. Retrograde fenestration and deployment of the balloon expandable stent-graft was performed sequentially for each supraaortic trunk. Subsequent to stent-graft explantation, macroscopic evaluation of each fenestration was performed. Results All attempts to fenestrate the C-TAG and Valiant stent-grafts and implant the covered stent through the supraaortic trunks were successful. In all cases, branch stents were patent and no endoleak was evident. The Valiant stent-graft was easier to puncture because of the higher radial force of the stent-graft providing better counterpressure; however, stent-graft material had no impact on the quality of fenestrations. Conclusions Total endovascular repair of the aortic arch through in situ retrograde fenestration of stent-grafts is feasible. The behavior of the 2 types of stent-graft was significantly different while the fenestrations were fashioned, but stent-graft material had no impact on the quality of fenestrations.
- Subjects :
- Adult
Male
Pulmonary and Respiratory Medicine
Aortic arch
medicine.medical_specialty
[SDV]Life Sciences [q-bio]
Aorta, Thoracic
Prosthesis Design
medicine.artery
Materials Testing
Ascending aorta
Cadaver
Humans
Medicine
cardiovascular diseases
Arch
Radial Force Variation
Covered stent
business.industry
Endovascular Procedures
Anatomy
Middle Aged
Plastic Surgery Procedures
equipment and supplies
Blood Vessel Prosthesis
Surgery
surgical procedures, operative
Balloon expandable stent
Feasibility Studies
Female
Stents
Implant
Cardiology and Cardiovascular Medicine
Fenestration
business
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 98
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....251ccb465e0f8c7dc42250ad6492a194