Cargando…
Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro
Purpose: To investigate in an in vitro model if secondary endobag filling can reduce gutter size during chimney endovascular aneurysm sealing (chEVAS). Materials and Methods: Nellix EVAS systems were deployed in 2 silicone juxtarenal aneurysm models with suprarenal aortic diameters of 19 and 24 mm....
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330694/ https://www.ncbi.nlm.nih.gov/pubmed/30572773 http://dx.doi.org/10.1177/1526602818819494 |
_version_ | 1783387015089225728 |
---|---|
author | van Schaik, Theodorus G. Meekel, Jorn P. Jongkind, Vincent Lely, Rutger J. Truijers, Maarten Hoksbergen, Arjan W. J. Wisselink, Willem Blankensteijn, Jan D. Yeung, Kak Khee |
author_facet | van Schaik, Theodorus G. Meekel, Jorn P. Jongkind, Vincent Lely, Rutger J. Truijers, Maarten Hoksbergen, Arjan W. J. Wisselink, Willem Blankensteijn, Jan D. Yeung, Kak Khee |
author_sort | van Schaik, Theodorus G. |
collection | PubMed |
description | Purpose: To investigate in an in vitro model if secondary endobag filling can reduce gutter size during chimney endovascular aneurysm sealing (chEVAS). Materials and Methods: Nellix EVAS systems were deployed in 2 silicone juxtarenal aneurysm models with suprarenal aortic diameters of 19 and 24 mm. Four configurations were tested: EVAS with 6-mm balloon-expandable (BE) or self-expanding (SE) chimney grafts (CGs) in the renal branches of both models. Balloons were inflated simultaneously in the CGs and main endografts during primary and secondary endobag filling and polymer curing. Computed tomography (CT) was performed immediately after the primary and secondary fills. Cross-sectional lumen areas were measured on the CT images to calculate gutter volumes and percent change. CG compression was calculated as the reduction in lumen surface area measured perpendicular to the central lumen line. The largest gutter volume and highest compression were presented per CG configuration per model. Results: Secondary endobag filling reduced the largest gutter volumes from 99.4 to 73.1 mm(3) (13.2% change) and 84.2 to 72.0 mm(3) (27.6% change) in the BECG configurations and from 67.2 to 44.0 mm(3) (34.5% change) and 92.7 to 82.3 mm(3) (11.2% change) in the SECG configurations in the 19- and 24-mm models, respectively. Secondary endobag filling increased CG compression in 6 of 8 configurations. BECG compression changed by −0.2% and 5.4% and by −1.0% and 0.4% in the 19- and 24-mm models, respectively. SECG compression changed by 10.2% and 16.0% and by 7.2% and 7.3% in the 19- and 24-mm models, respectively. Conclusion: Secondary endobag filling reduced paragraft gutters; however, this technique did not obliterate them. Increased CG compression and prolonged renal ischemia time should be considered if secondary endobag filling is used. |
format | Online Article Text |
id | pubmed-6330694 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-63306942019-01-29 Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro van Schaik, Theodorus G. Meekel, Jorn P. Jongkind, Vincent Lely, Rutger J. Truijers, Maarten Hoksbergen, Arjan W. J. Wisselink, Willem Blankensteijn, Jan D. Yeung, Kak Khee J Endovasc Ther Endovascular Aneurysm Sealing Purpose: To investigate in an in vitro model if secondary endobag filling can reduce gutter size during chimney endovascular aneurysm sealing (chEVAS). Materials and Methods: Nellix EVAS systems were deployed in 2 silicone juxtarenal aneurysm models with suprarenal aortic diameters of 19 and 24 mm. Four configurations were tested: EVAS with 6-mm balloon-expandable (BE) or self-expanding (SE) chimney grafts (CGs) in the renal branches of both models. Balloons were inflated simultaneously in the CGs and main endografts during primary and secondary endobag filling and polymer curing. Computed tomography (CT) was performed immediately after the primary and secondary fills. Cross-sectional lumen areas were measured on the CT images to calculate gutter volumes and percent change. CG compression was calculated as the reduction in lumen surface area measured perpendicular to the central lumen line. The largest gutter volume and highest compression were presented per CG configuration per model. Results: Secondary endobag filling reduced the largest gutter volumes from 99.4 to 73.1 mm(3) (13.2% change) and 84.2 to 72.0 mm(3) (27.6% change) in the BECG configurations and from 67.2 to 44.0 mm(3) (34.5% change) and 92.7 to 82.3 mm(3) (11.2% change) in the SECG configurations in the 19- and 24-mm models, respectively. Secondary endobag filling increased CG compression in 6 of 8 configurations. BECG compression changed by −0.2% and 5.4% and by −1.0% and 0.4% in the 19- and 24-mm models, respectively. SECG compression changed by 10.2% and 16.0% and by 7.2% and 7.3% in the 19- and 24-mm models, respectively. Conclusion: Secondary endobag filling reduced paragraft gutters; however, this technique did not obliterate them. Increased CG compression and prolonged renal ischemia time should be considered if secondary endobag filling is used. SAGE Publications 2018-12-21 2019-02 /pmc/articles/PMC6330694/ /pubmed/30572773 http://dx.doi.org/10.1177/1526602818819494 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Endovascular Aneurysm Sealing van Schaik, Theodorus G. Meekel, Jorn P. Jongkind, Vincent Lely, Rutger J. Truijers, Maarten Hoksbergen, Arjan W. J. Wisselink, Willem Blankensteijn, Jan D. Yeung, Kak Khee Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title | Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title_full | Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title_fullStr | Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title_full_unstemmed | Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title_short | Secondary Fill Minimizes Gutter Size in Chimney EVAS Configurations In Vitro |
title_sort | secondary fill minimizes gutter size in chimney evas configurations in vitro |
topic | Endovascular Aneurysm Sealing |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330694/ https://www.ncbi.nlm.nih.gov/pubmed/30572773 http://dx.doi.org/10.1177/1526602818819494 |
work_keys_str_mv | AT vanschaiktheodorusg secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT meekeljornp secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT jongkindvincent secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT lelyrutgerj secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT truijersmaarten secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT hoksbergenarjanwj secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT wisselinkwillem secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT blankensteijnjand secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro AT yeungkakkhee secondaryfillminimizesguttersizeinchimneyevasconfigurationsinvitro |