Er-Ping Xi1, Jian Zhu1, Shui-Bo Zhu1, Yu Zhang1, Gui-Hua Xu1. 1. Department of Thoracic Cardiovascular Surgery, Wuhan General Hospital of Guangzhou Command Wuhan 430070, Hubei Province, People's Republic of China.
Abstract
OBJECTIVE: To validate the feasibility and effectiveness of applying fenestrated stent grafts in canine aortic arches. METHODS: According to the anatomic characteristics of the aortic arches from four adult beagle dogs, a straight-type aortic coated vascular stent system from Lifetech Scientific (Shenzhen) Co., Ltd. was released in vitro, after which a square window was burnt out at the back tendon of the coated vascular stent with an electrocautery pen, and the fenestrated stent grafts were then returned in the catheter and delivery sheath, following the original release path. Endovascular aortic repair (EVAR) was then performed in the canine aorta. Immediately after surgery, digital subtraction angiography (DSA) and computed tomography (CT) angiography were conducted. On day 3, the dressing was changed, and on day 7, the stitches were removed and CT angiography was reviewed. Animal autopsies were performed 2 weeks after surgery. RESULTS: DSA and CT angiography were conducted in 4 beagles immediately after the experiments. The CT angiography reviewed on day 7 after surgery and the animal autopsy performed two weeks after surgery both revealed that the fenestrated stent grafts were anchored in the canine aortic arch, the openings were aligned against the branch vessels above the aortic arch, and in each branch vessel, the blood flow was smooth, without any obvious internal leakage phenomena. CONCLUSION: An ordinary straight-type coated vascular stent, fenestrated in vitro, followed by the performance of EVAR in the canine aortic arch for in vivo stent implantation, was technically feasible. When a branch coated vascular stent cannot meet the individual needs of the wound, this technology may provide a valuable strategy for clinical thoracic aortic trauma emergencies.
OBJECTIVE: To validate the feasibility and effectiveness of applying fenestrated stent grafts in canine aortic arches. METHODS: According to the anatomic characteristics of the aortic arches from four adult beagle dogs, a straight-type aortic coated vascular stent system from Lifetech Scientific (Shenzhen) Co., Ltd. was released in vitro, after which a square window was burnt out at the back tendon of the coated vascular stent with an electrocautery pen, and the fenestrated stent grafts were then returned in the catheter and delivery sheath, following the original release path. Endovascular aortic repair (EVAR) was then performed in the canine aorta. Immediately after surgery, digital subtraction angiography (DSA) and computed tomography (CT) angiography were conducted. On day 3, the dressing was changed, and on day 7, the stitches were removed and CT angiography was reviewed. Animal autopsies were performed 2 weeks after surgery. RESULTS: DSA and CT angiography were conducted in 4 beagles immediately after the experiments. The CT angiography reviewed on day 7 after surgery and the animal autopsy performed two weeks after surgery both revealed that the fenestrated stent grafts were anchored in the canine aortic arch, the openings were aligned against the branch vessels above the aortic arch, and in each branch vessel, the blood flow was smooth, without any obvious internal leakage phenomena. CONCLUSION: An ordinary straight-type coated vascular stent, fenestrated in vitro, followed by the performance of EVAR in the canine aortic arch for in vivo stent implantation, was technically feasible. When a branch coated vascular stent cannot meet the individual needs of the wound, this technology may provide a valuable strategy for clinical thoracic aortic trauma emergencies.
Authors: G A Antoniou; M Mireskandari; C D Bicknell; N J W Cheshire; R G Gibbs; M Hamady; J H N Wolfe; M P Jenkins Journal: Eur J Vasc Endovasc Surg Date: 2010-12 Impact factor: 7.069
Authors: Demetrios Demetriades; George C Velmahos; Thomas M Scalea; Gregory J Jurkovich; Riyad Karmy-Jones; Pedro G Teixeira; Mark R Hemmila; James V O'Connor; Mark O McKenney; Forrest O Moore; Jason London; Michael J Singh; Edward Lineen; Konstantinos Spaniolas; Marius Keel; Michael Sugrue; Wendy L Wahl; Jonathan Hill; Mathew J Wall; Ernest E Moore; Daniel Margulies; Valerie Malka; Linda S Chan Journal: J Trauma Date: 2008-03