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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 9/2019

01-09-2019 | Laboratory Investigation

Histologic Analysis with the Newly Designed Exoskeleton Seal® Stent-Graft in the Porcine Abdominal Aorta

Authors: Jung-Hoon Park, Young Kwon Cho, Keun Her, Yong Sun Jeon, Jeong Ho Kim, Tae-Seok Seo, Myung Gyu Song

Published in: CardioVascular and Interventional Radiology | Issue 9/2019

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Abstract

Purpose

To investigate the technical feasibility of a novel exoskeleton Seal® stent-graft and analyze early histologic changes in the porcine abdominal aorta.

Materials and Methods

Six pigs received an abdominal stent-graft (Group I), and six received an iliac branch stent-graft (Group II). Groups were subdivided as follows: Group Ia, which received three bifurcated main-body stent-grafts; Group Ib, which received three bifurcated main-body stent-grafts with both iliac graft-stents; Group IIa, which received three simple uni-iliac tapered stent-grafts; and Group IIb, which received three uni-iliac tapered tapered stent-grafts with right straight limb and left branched limb. Statistical analyses were performed with the Wilcoxon signed-rank test and mixed-model regression analysis.

Results

The primary technical success rate (< 24 h) was 83% because of two acute thromboses in the lumen of the stented abdominal aorta immediately after stent-graft placement. At 4 weeks, late thrombosis occurred in two pigs. Higher mean neointimal hyperplasia areas (23.5% vs. 16.2%; P = .047), neointimal hyperplasia thicknesses (545.5 μm vs. 422.2 μm; P = .001), and degrees of collagen deposition (2.71 vs. 2.33; P = .002) were observed at the bare-metal stent-graft compared with the proximal exoskeleton portion of the stent-graft, with no significant differences between the patent and occluded groups or among the four types of stent-grafts.

Conclusions

The exoskeleton stent-graft demonstrates 66% of patency rate during 1-month follow-up due to four cases of thromboses; however, the endothelialization on the junction of proximal graft showed no significant differences between the patent and occluded groups. Further studies should investigate long-term outcomes with prolonged neointimal hyperplasia.
Literature
1.
Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg. 1991;5:491–9.CrossRefPubMed
2.
Bashar AH, Kazui T, Terada H, Suzuki K, Washiyama N, Yamashita K, et al. Histological changes in canine aorta 1 year after stent-graft implantation: implications for the long-term stability of device anchoring zones. J Endovasc Ther. 2002;9:320–32.CrossRefPubMed
3.
Wu MH, Shi Q, Onuki Y, Kouchi Y, Sauvage LR. Histologic observation of continuity of transmural microvessels between the perigraft vessels and flow surface microostia in a porous vascular prosthesis. Ann Vasc Surg. 1996;10:11–5.CrossRefPubMed
4.
Spanos K, Karathanos C, Saleptsis V, Giannoukas AD. Systematic review and meta-analysis of migration after endovascular abdominal aortic aneurysm repair. Vascular. 2016;24:323–36.CrossRefPubMed
5.
Kent F, Ambler GK, Bosanquet DC, Twine CP, BSET (British Society for Endovascular Therapy). The safety of device registries for endovascular abdominal aortic aneurysm repair: systematic review and meta-regression. Eur J Vasc Endovasc Surg. 2018;55(2):177–83.CrossRefPubMed
6.
Steuer J, Lachat M, Veith FJ, Wanhainen A. Endovascular grafts for abdominal aortic aneurysm. Eur Heart J. 2016;37(2):145–51.CrossRefPubMed
7.
Maldonado TS, Mosquera NJ, Lin P, Bellosta R, Barfield M, Moussa A, et al. Gore Iliac Branch Endoprosthesis for treatment of bilateral common iliac artery aneurysms. J Vasc Surg. 2018;68:100–8.CrossRefPubMed
8.
Schneider DB, Matsumura JS, Lee JT, Peterson BG, Chaer RA, Oderich GS. Prospective, multicenter study of endovascular repair of aortoiliac and iliac aneurysms using the Gore Iliac Branch Endoprosthesis. J Vasc Surg. 2017;66:775–85.CrossRefPubMed
9.
Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK, Bernhard VM, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1048–60.CrossRefPubMed
10.
Li YD, Song HY, Kim JH, Woo CW, Park JH, Kim TH, et al. Evaluation of formation of granulation tissue caused by metallic stent placement in a rat urethral model. J Vasc Interv Radiol. 2010;21(12):1884–90.CrossRefPubMed
11.
Gorin DR, Arbid EJ, D’Agostino R, Yucel EK, Solovay KS, La Morte WW, et al. A new generation endovascular graft for repair of abdominal aortic aneurysms. Am J Surg. 1997;173:159–64.CrossRefPubMed
12.
Deery SE, Shean KE, Pothof AB, O’Donnell TFX, Dalebout BA, Darling JD, et al. Three-year results of the Endurant Stent Graft System Post Approval Study. Ann Vasc Surg. 2018;50:202–8.CrossRefPubMedPubMedCentral
13.
Lambert AW, Budd JS, Fox AD, Potter U, Rooney N, Horrocks M. The incorporation of a stent-graft into the porcine aorta and the inflammatory response to the endoprosthesis. Cardiovasc Surg. 1999;7:710–4.CrossRefPubMed
14.
Kim YI, Choi YH, Chung JW, Kim HC, So YH, Kim HB, et al. Tissue responses to stent grafts with endo-exo-skeleton for saccular abdominal aortic aneurysms in a canine model. Korean J Radiol. 2014;15:622–9.CrossRefPubMedPubMedCentral
15.
Kim HB, Choi YH, So YH, Min SK, Kim HC, Kim YI, et al. Tissue responses to endovascular stent grafts for saccular abdominal aortic aneurysms in a canine model. J Korean Med Sci. 2012;27:1170–6.CrossRefPubMedPubMedCentral
16.
Kim JH, Cho YK, Seo TS, Song MG, Jeon YS, Han YM, et al. Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft. J Vasc Surg. 2016;64:1270–7.CrossRefPubMed
17.
Calero A, Illig KA. Overview of aortic aneurysm management in the endovascular era. Semin Vasc Surg. 2016;29:3–17.CrossRefPubMed
18.
Yavuz K, Geyik S, Pavcnik D, Uchida BT, Corless CL, Hartley DE, et al. Comparison of the endothelialization of small intestinal submucosa, dacron, and expanded polytetrafluoroethylene suspended in the thoracoabdominal aorta in sheep. J Vasc Interv Radiol. 2006;17:873–82.CrossRefPubMed
19.
Guidoin R, Chakfé N, Maurel S, How T, Batt M, Marios M, et al. Expanded polytetrafluoroethylene arterial prostheses in humans: histopathological study of 298 surgically excised grafts. Biomaterials. 1993;14:678–93.CrossRefPubMed
20.
Sincos IR, da Silva ES, Belczak SQ, Baptista Sincos AP, de Lourdes Higuchi M, Gornati V, et al. Histologic analysis of stent graft oversizing in the thoracic aorta. J Vasc Surg. 2013;58:1644–51.CrossRefPubMed
21.
van der Bas JM, Quax PH, van den Berg AC, van Hinsbergh VW, van Bockel JH. Ingrowth of aorta vascular cells into basic fibroblast growth factor-impregnated vascular prosthesis material: a porcine and human in vitro study on blood vessel prosthesis healing. J Vasc Surg. 2002;36:1237–47.CrossRefPubMed
Metadata
Title
Histologic Analysis with the Newly Designed Exoskeleton Seal® Stent-Graft in the Porcine Abdominal Aorta
Authors
Jung-Hoon Park
Young Kwon Cho
Keun Her
Yong Sun Jeon
Jeong Ho Kim
Tae-Seok Seo
Myung Gyu Song
Publication date
01-09-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 9/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02261-2

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