Endovascular Stent-Graft Repair of the Ascending Aorta: Assessment of a Specific Novel Stent-Graft Design in Phantom, Cadaveric, and Clinical Application
Autor: | Marek Ehrlich, Marlies Stelzmüller, Sven R Hauck, Christoph Neumayer, Florian Wolf, Martin Funovics, Wolf Eilenberg, Alexander Kupferthaler, Christian Loewe |
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Rok vydání: | 2021 |
Předmět: |
Male
medicine.medical_treatment 030204 cardiovascular system & hematology Prosthesis Design Curvature Imaging phantom Blood Vessel Prosthesis Implantation 03 medical and health sciences Pseudoaneurysm 0302 clinical medicine Cadaver medicine.artery Ascending aorta medicine Humans Radiology Nuclear Medicine and imaging Aorta Aged business.industry Endovascular Procedures Stent Ascending aortic stent-graft Ascending TEVAR equipment and supplies medicine.disease Blood Vessel Prosthesis surgical procedures operative Treatment Outcome 030228 respiratory system Custom-made stentgraft Landing zone Laboratory Investigation Stents Cardiology and Cardiovascular Medicine business Cadaveric spasm Biomedical engineering |
Zdroj: | Cardiovascular and Interventional Radiology |
ISSN: | 1432-086X 0174-1551 |
Popis: | Purpose To test a stent-graft specifically designed for the ascending aorta in phantom, cadaver, and clinical application, and to measure deployment accuracy to overcome limitations of existing devices. Methods A stent-graft has been designed with support wires to fixate the apices toward the inner curvature, thereby eliminating the forward movement of the proximal end which can happen with circumferential tip capture systems. The device was deployed in three aortic phantoms, and in four cadavers, deployment precision was measured. Subsequently, the device was implanted in a patient to exclude a pseudoaneurysm originating from the distal anastomosis after ascending aortic replacement. Results The stent-grafts were successfully deployed in all phantoms and cadavers. Deployment accuracy of the proximal end of the stent-graft was within 1 mm proximally and 14 mm distally to the intended landing zone on the inner curvature, and 2–8 mm distal to the intended landing zone on the outer curvature. In clinical application, the pseudoaneurysm could be successfully excluded without complications. Conclusion The novel stent-graft design promises accurate placement in the ascending aorta. The differential deployment of the apices at the inner and outer curvatures allows deployment perpendicular to the aortic axis. Level of Evidence No level of evidence. |
Databáze: | OpenAIRE |
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