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Presentation transcript:

Assessing the effectiveness of endografts: Clinical and experimental perspectives Larisse K. Lee, MD, Peter L. Faries, MD Journal of Vascular Surgery Volume 45, Issue 6, Pages A123-A130 (June 2007) DOI: 10.1016/j.jvs.2007.02.047 Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 1 Prosthetic polytetrafluoroethylene aneurysm with attached pressure transducer. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 2 Implanted prosthetic aneurysm with side branch vessel implanted (arrow) in posterior aspect of aneurysm. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 3 Digital subtraction angiogram of stent graft deployment. A, Aneurysm before deployment with antegrade flow through reimplanted lumbar artery (black arrow) and pressure transducer (white arrow). B, After stent graft deployment. C, An 8-second delay shows retrograde opacification of reimplanted lumbar artery (black arrow) leading to type II endoleak. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 4 Type II endoleak schematic. A, Aneurysm created by dilatation of polytetrafluoroethylene with implanted lumbar arteries and pressure transducer (T). B, Stent graft (SG) deployment. C, Polyurethane foam (PUF) implanted into the aneurysm sac at the time of stent-graft deployment. EVG, Endovascular graft. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 5 Model of in vivo infrarenal abdominal aortic aneurysm formation in swine is shown in an intraoperative photograph. The abdominal aorta is isolated and dilated with an angioplasty balloon. A perfusate of collagenase and elastase is instilled under pressure. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 6 Aneurysm formation confirmed by magnetic resonance angiography. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 7 Abdominal aorta explanted 3 weeks postoperatively demonstrates marked dilation in the infrarenal segment. The renal arteries are visible, flanking the aneurysm superiorly, and a normal porcine trifurcation is evident inferiorly. Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions

Fig 8 A, A specimen of normal porcine aortic wall demonstrates tightly coiled regular elastic membranes. B, Tissue harvested from the aneurysm demonstrates elastin fragmentation and fraying (double arrow), and straightening of elastic coils (single arrow). Journal of Vascular Surgery 2007 45, A123-A130DOI: (10.1016/j.jvs.2007.02.047) Copyright © 2007 The Society for Vascular Surgery Terms and Conditions