Role of aortic stent graft oversizing and barb characteristics on folding Kathleen K. Lin, BS, Jarin A. Kratzberg, PhD, Madhavan L. Raghavan, PhD Journal.

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Role of aortic stent graft oversizing and barb characteristics on folding Kathleen K. Lin, BS, Jarin A. Kratzberg, PhD, Madhavan L. Raghavan, PhD Journal of Vascular Surgery Volume 55, Issue 5, Pages 1401-1409 (May 2012) DOI: 10.1016/j.jvs.2011.10.080 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Illustration of stent graft barb characteristics studied shows barb length (BL) and barb angle (BA). Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Schematic of the pulsatile flow loop used for experiments.9 Compliant tubing and pinch valves serve as compliance and resistance chambers for pulse pressure and flow control. The bypass tube helps eliminate unrealistic spiking of pressure when the flow is partially or fully obstructed during endovascular graft (EVG) deployment. AAA, Abdominal aortic aneurysm. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 A, Visualization of computed tomography (CT) slices on Syngo CT using rotations and oblique slicing. B, Three-dimensional reconstruction, volume rendering, and visualization of CT image volume using Mimics software. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Cross-sectional view of 26-mm-diameter stent graft deployed freely in air. B, Front half of stent graft after coronal slice. C, Back half of stent graft after coronal slice. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 Schematic of (A) proper apposition of stent graft in aorta with no folding, (B) longitudinal folding, and (C) circumferential folding. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 6 Representative examples of various ranks and types of folding observed. No mild, longitudinal folding occurred. The dotted lines on long views indicate the location of the cross-sectional slice shown above them. The block arrows indicate regions of folding observed. Note that the deployed stent configuration for rank 0 is as good as that in the control (see Fig 4). A-D, Circumferential folding is characterized by overlap in the perimeter highlighted by the stent struts on cross-sectional views. E-G, Longitudinal folding is characterized by a gap in the perimeter highlighted by the lack of stent struts on the cross-sectional view plane. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 7 Folding levels observed due to variations in (A) oversizing and barb length, (B) oversizing and barb angle, and (C) all perturbed variables. When one variable was perturbed, the others were maintained constant. Note that among the three variables, folding was mainly affected by increased oversizing, except for one outlier at 13% oversizing. When oversized within 10% to 20%, barb length and angle do not cause folding. Journal of Vascular Surgery 2012 55, 1401-1409DOI: (10.1016/j.jvs.2011.10.080) Copyright © 2012 Society for Vascular Surgery Terms and Conditions