Analysis of Explanted Latecba Modular Stent-grafts Deployed Transrenally to Repair AAAs with Short Necks in 29 Dogs

Abstract

Twenty-nine modular stent-grafts deployed transrenally to repair AAAs with short necks in dogs were harvested at autopsy of the animals after scheduled durations of implantations of 10 days, one month, three months, and six months. Analyses of the explanted devices included non-destructive techniques such as gross observations, X-rays CT scan, IVUS and angioscopy. Further to appropriate dissection, histological investigations were carried out by means of scanning electron microscopy (SEM) and light microscopy. All the 29 specimens were extensively encapsulated with fibrous tissues but the fibrous capsule was thin in six of them; four capsules were ulcerated. The X-rays confirmed the stability of the devices that were still straight (12), slightly bent (12) or bent (4). The modules were misaligned in only one case. IVUS and angioscopy confirmed the patency of all the stent-grafts with thin internal capsules both proximally and distally with variable capsulation in the mid-section of the grafts. The left renal artery orifices were found to be patent at dissection with no obstruction to flow. The luminal flow surface of the stent-grafts was smooth and glistening proximally and distally containing endothelial like cells and vasa-vasorum. Poor healing was noted in the aneurysm area. Transrenal deployment of this modular stent-graft is feasible and gave excellent results with regard to biofunctionality and biocompatibility. The device proved to be safe and efficient.

Size of the Proximal Neck in AAAs Treated With Balloon-Expandable Stent-Grafts: CTA Findings in Mid- to Long-term Follow-up

“…Complete healing of the proximal neck has been seen experimentally in dogs. 40,41 This incorporation of the device with the host artery likely improves the mechanical and hemodynamic characteristics of the site. The internal capsule is well developed, with endothelial-like cells on the flow surface (Fig.…”

A Branched, Balloon-Deployable, Aortomonoiliac Stent-Graft for Treatment of AAA in a Patient With a Solitary Intrapelvic Kidney

“…In addition, the selection of a weft-knitted fabric rather than a weave permits better incorporation of the textile wall into the tissues, thus acting as a scaffold for complete encapsulation of the device. 8 We prefer this device based upon its capacity to both treat the complicated pathology and promote enhanced biological fixation compared to other available devices. Considering the anatomy and comorbidities of our patient, we feel confident that the treatment that we proposed was the most appropriate.…”

“…Manufacturers are currently making customized devices with one or more branches and/or fenestrations for specific patients with complicated anatomy for which standard infrarenal devices would be insufficient. We report our experience with the deployment of a customized, branched, balloon-deployable stent-graft based upon performance data from previous clinical 6 and experimental 7,8 data.…”

The marvel of percutaneous cardiovascular devices in the elderly

“…As endovascular surgery is here to stay, the additional contribution of engineers and basic scientists will further enhance the next generations of devices. The next challenge facing us on the horizon will be the successful recanalization of the aorta by way of a well encapsulated scaffold with a fully endothelialized flow surface 46 …”

“…The next challenge facing us on the horizon will be the successful recanalization of the aorta by way of a well encapsulated scaffold with a fully endothelialized flow surface. 46…”