Alexander Gombert1, Larissa Hussmann2, Drosos Kotelis2, Jochen Grommes2, Alexander Löwen3, Valentine N Gesche3, Sabrina Thies2, Andrij Pich2, Thomas Gries4, Stefan Jockenhövel5, Michael J Jacobs1, Andreas Greiner6. 1. European Vascular Center Aachen-Maastricht, Universitätsklinikum RWTH Aachen, Deutschland. 2. DWI - Leibniz-Institut für Interaktive Materialien e. V., RWTH Aachen, Deutschland. 3. Biohybrid & Medical Textiles, Institut für Textiltechnik, European Vascular Center Aachen-Maastricht, Universitätsklinikum RWTH Aachen, Deutschland. 4. Lehr- und Forschungsgebiet Tissue Engineering & Textile Implants, Institut für Textiltechnik, European Vascular Center Aachen-Maastricht, Universitätsklinikum RWTH Aachen, Deutschland. 5. NRW Schwerpunktprofessur Biohybrid & Medical Textiles AME - Helmholtz Institute for Biomedical Engineering, European Vascular Center Aachen-Maastricht, Universitätsklinikum RWTH Aachen, Deutschland. 6. Klinik für Gefäßchirurgie, Charité - Universitätsmedizin Berlin, Deutschland.
Abstract
INTRODUCTION: The risk of spinal cord ischemia is a relevant problem in in fields of open and endovascular thoracoabdominal aortic aneurysm repair (TAAA). Despite all efforts, no therapeutical concept exists, which enables a complete treatment of the TAAA without open branches or fenestrations, and reduces the risk for a spinal cord ischemia (SCI) to the minimum. In this article, we would like to present a new concept based on slow-occluding hydrogel-textile membrane, which could help to reduce the SCI risk during endovascular TAAA repair. CONCEPT: A hydrogel textile membrane is under development, which could be used a functional unit of endovascular stentprosthesis. If in contact with blood, glutathion induces swelling of the induces ongoing swelling of the membrane because of the triggered degradation of the crosslinker. Due to the resulting water uptake of the hydrogel textile membrane and mass increase of the gel, the swelling leads to a stabilization of the membrane. In vitro studies show, that the swelling of the hydrogel textile membrane should lead to a controlled decreasing flow into the aneurysm sac. After a pre-defined period, the membrane is occluded and the aneurysm sac perfusion stops. So, by using the hydrogel textile membrane, a complete treatment of the TAAA can be realized in one procedure without further re-intervention or pre-interventional measures. Furthermore, the risk of a SCI would be minimized. As this treatment concept is under development, only interim results are presented. CONCLUSION: The successful development and usage of a slow-occluding hydrogel textile membrane as a part of endovascular stentprosthesis could help to reduce the risk SCI during endovascular TAAA surgery. Georg Thieme Verlag KG Stuttgart · New York.
INTRODUCTION: The risk of spinal cord ischemia is a relevant problem in in fields of open and endovascular thoracoabdominal aortic aneurysm repair (TAAA). Despite all efforts, no therapeutical concept exists, which enables a complete treatment of the TAAA without open branches or fenestrations, and reduces the risk for a spinal cord ischemia (SCI) to the minimum. In this article, we would like to present a new concept based on slow-occluding hydrogel-textile membrane, which could help to reduce the SCI risk during endovascular TAAA repair. CONCEPT: A hydrogel textile membrane is under development, which could be used a functional unit of endovascular stentprosthesis. If in contact with blood, glutathion induces swelling of the induces ongoing swelling of the membrane because of the triggered degradation of the crosslinker. Due to the resulting water uptake of the hydrogel textile membrane and mass increase of the gel, the swelling leads to a stabilization of the membrane. In vitro studies show, that the swelling of the hydrogel textile membrane should lead to a controlled decreasing flow into the aneurysm sac. After a pre-defined period, the membrane is occluded and the aneurysm sac perfusion stops. So, by using the hydrogel textile membrane, a complete treatment of the TAAA can be realized in one procedure without further re-intervention or pre-interventional measures. Furthermore, the risk of a SCI would be minimized. As this treatment concept is under development, only interim results are presented. CONCLUSION: The successful development and usage of a slow-occluding hydrogel textile membrane as a part of endovascular stentprosthesis could help to reduce the risk SCI during endovascular TAAA surgery. Georg Thieme Verlag KG Stuttgart · New York.