Transfemoral placement of intraluminal polyurethane prosthesis for abdominal aortic aneurysm

Endoluminal Exclusion of Abdominal Aortic Aneurysms

“…Experimental evaluation of endoluminal AAA exclusion Balko et al 43 first demonstrated that AAAs could be treated by transfemoral placement of an intraluminal prosthesis. In three sheep, artificially created aortic aneurysms were successfully excluded from the arterial circulation using a polyurethane graft with a Nitinol or stainless steel frame providing attachment to the aortic wall.…”

“…The introduction of balloon expandable stents led to modification of the technique originally described by Balko et al 43 Laborde et al 46 performed intraluminal bypass of a prosthetic canine abdominal aortic aneurysm by using a Dacron graft with a balloon expandable stent (Palmaz stent) attached to both ends (cranially and caudally) of the graft, the middle portion of the graft being unsupported. This graft-stent combination was inserted transfemorally through an introducer sheath and the cranial stent was expanded just above the aneurysm neck by means of a balloon angioplasty catheter.…”

Endograft Sizing for Abdominal Aortic Aneurysms

“…Since wires were not a feasible solution to exclude the aneurysm sac, several attempts were made testing intraluminal grafts in animals [9][10][11][12][13]. Balko et al [10] used 10 mm intraluminal polyurethane prosthesis with a compressible Nitinol wire frame in a 9 mm self-made aneurysm in sheep. Laborde et al [13] used 10 mm modified tubular Dacron grafts affixed to balloonexpandable stents and applied it to 10 mm mongrel vessels and found inconsistent results; yet, they recommended expanding the stent to a diameter 10-15% larger than the aorta.…”

“…In 1983, Nitinol wires were inserted in animals using a transluminal approach with only the stent dimensions reported [19,20]. Since wires were not a feasible solution to exclude the aneurysm sac, several attempts were made testing intraluminal grafts in animals [9][10][11][12][13]. Balko et al [10] used 10 mm intraluminal polyurethane prosthesis with a compressible Nitinol wire frame in a 9 mm self-made aneurysm in sheep.…”

“…Several others went on to test the intraluminal grafts in animals with an array of sizing protocols [10][11][12][13]. However, it is difficult to interpret sizing practices from these early studies since most involved balloon-expandable stents and not the self-expandable stents that are frequently used today.…”