PURPOSE: To describe the histological findings in the aortic wall 5 days after thoracic endovascular aortic repair (TEVAR) in a porcine model. METHODS: Two overlapping stent-grafts were implanted in each of 6 juvenile pigs, covering the entire descending thoracic aorta (DTA). On the 5(th) postoperative day, tissue samples were taken from the DTA in each animal. Medial thickness and medial necrosis were quantified and compared to measurements from the aortas of 6 control animals. RESULTS: Significant medial thinning was observed in stent-covered regions in the test animals. At the proximal landing zone, aortic wall thickness changed from 1387±68 to 782±74 µm within the covered aortic segment (p = 0.028); at the distal landing site, the wall thickness was 365±67 µm within the stent and 501±57 µm distally (p = 0.028). In the overlap zone, the aortic wall measured 524±122 vs. 1053±77 µm in native controls (p = 0.004). Aortic thickness proximal to the graft did not differ from the proximal region of native aortas (1468±96 vs. 1513±80 µm, p = 0.423), but the aorta was significantly thinner distal to the stent (707±38 vs. 815±52 µm, p = 0.004). Laminar necrosis constituted 38%±7% of the media in the proximal landing zone, 54%±4% in the overlap zone, and 46%±13% in the distal landing zone. CONCLUSION: In this porcine model, significant medial thinning and necrosis of the stented aorta was observed. The findings suggest an early phase of vulnerability of the aortic wall, before scarring and adaptive changes have strengthened the residual aorta.
PURPOSE: To describe the histological findings in the aortic wall 5 days after thoracic endovascular aortic repair (TEVAR) in a porcine model. METHODS: Two overlapping stent-grafts were implanted in each of 6 juvenile pigs, covering the entire descending thoracic aorta (DTA). On the 5(th) postoperative day, tissue samples were taken from the DTA in each animal. Medial thickness and medial necrosis were quantified and compared to measurements from the aortas of 6 control animals. RESULTS: Significant medial thinning was observed in stent-covered regions in the test animals. At the proximal landing zone, aortic wall thickness changed from 1387±68 to 782±74 µm within the covered aortic segment (p = 0.028); at the distal landing site, the wall thickness was 365±67 µm within the stent and 501±57 µm distally (p = 0.028). In the overlap zone, the aortic wall measured 524±122 vs. 1053±77 µm in native controls (p = 0.004). Aortic thickness proximal to the graft did not differ from the proximal region of native aortas (1468±96 vs. 1513±80 µm, p = 0.423), but the aorta was significantly thinner distal to the stent (707±38 vs. 815±52 µm, p = 0.004). Laminar necrosis constituted 38%±7% of the media in the proximal landing zone, 54%±4% in the overlap zone, and 46%±13% in the distal landing zone. CONCLUSION: In this porcine model, significant medial thinning and necrosis of the stented aorta was observed. The findings suggest an early phase of vulnerability of the aortic wall, before scarring and adaptive changes have strengthened the residual aorta.
Authors: Moritz S Bischoff; Johannes Scheumann; Robert M Brenner; Dennis Ladage; Carol A Bodian; George Kleinman; Sharif H Ellozy; Gabriele Di Luozzo; Christian D Etz; Randall B Griepp Journal: Ann Thorac Surg Date: 2011-07 Impact factor: 4.330
Authors: Igor Rafael Sincos; Ricardo Aun; Erasmo Simão da Silva; Sergio Belczak; Maria de Lourdes Higuchi; Vitor Cervantes Gornati; Pedro Nogueira Gigglio; Anna Paula Weinhardt Baptista; Luiz Francisco Poli de Figueiredo Journal: J Endovasc Ther Date: 2011-08 Impact factor: 3.487
Authors: H Rousseau; J Puel; F Joffre; U Sigwart; C Duboucher; C Imbert; C Knight; L Kropf; H Wallsten Journal: Radiology Date: 1987-09 Impact factor: 11.105
Authors: Marcelo José Almeida; Winston Bonetti Yoshida; Ludvig Hafner; Julio Sequeira; Juliana Henriques Dos Santos; Ana Paula Batista Masseno; José Bitu Moreno; Sílvia de Sá Lorena Journal: J Vasc Surg Date: 2011-02-18 Impact factor: 4.268