The Mechanical Properties of Endovascular Stents: An In Vitro Assessment

Johnston, Clifton R.; Lee, Kogan; Flewitt, Jacqueline; Moore, Randy D.; Dobson, Gary; Thornton, Gail M.

doi:10.1007/s10558-010-9097-9

Cited by 27 publications

(23 citation statements)

References 22 publications

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“…Both H&E and confocal imagings showed fewer smooth muscle cells in the vein wall under the stent base suggesting a mild focal fibrosis due to the oversized stent base and resultant focal compression. In comparison, the Gianturco stainless steel stent (OD 24 mm and length 55 mm), which has been used for treatment of superior vena cava syndrome [ 28 ], showed a radial force of approximately 2 N when crimped 37.5% [ 29 ]. The compression degree was extrapolated to match the average size of the vena cava in this study.…”

Section: Discussionmentioning

confidence: 92%

Evaluation of a Bioabsorbable Self-Expandable Vein Stent-Base Made of Poly(l-lactide) In Vitro and In Vivo

Løvdal

Calve

Yang

et al. 2016

Cardiovasc Intervent Radiol

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Section: Discussionmentioning

confidence: 92%

Evaluation of a Bioabsorbable Self-Expandable Vein Stent-Base Made of Poly(l-lactide) In Vitro and In Vivo

Løvdal

Calve

Yang

et al. 2016

Cardiovasc Intervent Radiol

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“…1,7 However, data are limited on the interaction between the stent-graft and the aortic wall with regard to biomechanics and inflammatory and structural changes. [8][9][10][11][12][13] In this study, we analyzed histological alterations 5 days after TEVAR in a porcine model and found significant aortic wall thinning and luminal necrosis in every specimen covered by the stent.…”

Section: Discussionmentioning

confidence: 95%

Early Histological Changes in the Porcine Aortic Media After Thoracic Stent-Graft Implantation

Scheumann

Heilmann²,

Beyersdorf³

et al. 2012

Journal of Endovascular Therapy

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¤ ¤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 1387668 to 782674 mm within the covered aortic segment (p50.028); at the distal landing site, the wall thickness was 365667 mm within the stent and 501657 mm distally (p50.028). In the overlap zone, the aortic wall measured 5246122 vs. 1053677 mm in native controls (p50.004). Aortic thickness proximal to the graft did not differ from the proximal region of native aortas (1468696 vs. 1513680 mm, p50.423), but the aorta was significantly thinner distal to the stent (707638 vs. 815652 mm, p50.004). Laminar necrosis constituted 38%67% of the media in the proximal landing zone, 54%64% in the overlap zone, and 46%613% 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.

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“…When a stent is apposed to an artery, the force created from the vessel wall opposes a stent's outward radial force. After deployment, equilibrium is achieved between the vessel and stent-graft where the radial force is proportional to the final diameter of the incorporated device [23]. Thus, radial force is significantly correlated with the degree of oversizing.…”

Section: Biomechanics and Vessel Remodelingmentioning

confidence: 99%

Endograft Sizing for Abdominal Aortic Aneurysms

Sher¹,

Tadros²

2017

Aortic Aneurysm

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While a tight seal and fixation of aortic stent-grafts to the vessel wall are vital for positive outcomes in treating abdominal aortic aneurysms (AAAs), optimal aortic stent-graft sizing for endovascular aneurysm repair (EVAR) remains debatable. We performed a holistic review of the data surrounding the sizing of endografts using instructions for use (IFU) guidelines, as well as experimental, computational, and clinical studies. Most clinical studies that have investigated the role of sizing and outcomes are limited by the strict selection criteria, or the inability to account for the multitude of confounders associated with sizing. Currently, oversizing of endografts between 10 and 20% remains safe and favored, but sizing outside the IFU guidelines frequently occurs. Oversizing up to 25% appears to be associated with decreased rates of proximal endoleak and aneurysm sac enlargement, while excessive oversizing (>30%) has been linked to graft infolding, collapse, and aortic dilatation. It is unclear, however, whether there is an association between oversizing associated with neck dilatation and graft migration. During sizing, surgeons should take an individual approach and consider several factors including device type, calcification and/or thrombus of apposition site, hemodynamics, and aortoiliac morphology.

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The Mechanical Properties of Endovascular Stents: An In Vitro Assessment

Cited by 27 publications

References 22 publications

Evaluation of a Bioabsorbable Self-Expandable Vein Stent-Base Made of Poly(l-lactide) In Vitro and In Vivo

Evaluation of a Bioabsorbable Self-Expandable Vein Stent-Base Made of Poly(l-lactide) In Vitro and In Vivo

Early Histological Changes in the Porcine Aortic Media After Thoracic Stent-Graft Implantation

Endograft Sizing for Abdominal Aortic Aneurysms

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