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Aortic and iliac fixation of seven endografts for abdominal-aortic aneurysm repair in an experimental model using human cadaveric aortas.

TitleAortic and iliac fixation of seven endografts for abdominal-aortic aneurysm repair in an experimental model using human cadaveric aortas.
Publication TypeJournal Article
Year of Publication2010
AuthorsMelas, N., Saratzis A., Saratzis N., Lazaridis J., Psaroulis D., Trygonis K., & Kiskinis D.
JournalEur J Vasc Endovasc Surg
Volume40
Issue4
Pagination429-35
Date Published2010 Oct
ISSN1532-2165
KeywordsAged, Aged, 80 and over, Analysis of Variance, Aortic Aneurysm, Abdominal, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation, Cadaver, Catheterization, Female, Foreign-Body Migration, Humans, Iliac Artery, Male, Middle Aged, Prosthesis Design, Statistics, Nonparametric, Stents, Vascular Surgical Procedures
Abstract

OBJECTIVE: To evaluate the proximal and distal (iliac) fixation of seven self-expanding endografts, used in the endovascular treatment (EVAR) of abdominal-aortic aneurysm (AAA), by measuring the displacement force (DF) necessary to dislocate the devices from their fixation sites.METHODS: A total of 20 human cadaveric aortas were exposed, left in situ and transected to serve as fixation zones. The Anaconda, EndoFit aorto-uni-iliac, Endurant, Powerlink, Excluder, Talent and Zenith stent grafts were deployed and caudal force was applied at the flow divider, through a force gauge. The DF needed to dislocate each device ≥ 20 mm from the infrarenal neck was recorded before and after moulding-balloon dilatation. Cephalad force was similarly applied to each iliac limb to assess distal fixation before and after moulding-balloon dilatation.RESULTS: Endografts with fixation hooks or barbs displayed a significantly higher DF necessary to dislocate the proximal portion compared with devices with no such fixation modalities (p < 0.001). Balloon dilatation produced a significant increase in DF in both devices with (p < 0.001) or without (p = 0.003) hooks or barbs. Suprarenal support did not enhance proximal fixation (p = 0.90). Balloon dilatation significantly increased the DF necessary to dislodge the iliac limbs (p = 0.007).CONCLUSIONS: Devices with fixation hooks displayed higher proximal fixation. Moulding-balloon dilatation increased proximal and distal fixation. Suprarenal support did not affect proximal fixation.

DOI10.1016/j.ejvs.2010.07.007
Alternate JournalEur J Vasc Endovasc Surg
PubMed ID20696599

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