Document Detail


Role of aortic stent graft oversizing and barb characteristics on folding.
MedLine Citation:
PMID:  22305271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate folding in infrarenal stent grafts in relation to oversizing, barb angle, and barb length using computed tomography images of stent grafts deployed in explanted bovine aortas.
METHODS: Computed tomography data from an in vitro investigation on the effect of oversizing of 4% to 45% (n = 19), barb length of 2 to 7 mm (n = 11), and barb angle of 10° to 90° (n = 7) on device fixation were examined for instances of folding. Folding was classified as circumferential or longitudinal and quantified on an ordinal scale based on codified criteria. Cumulative fold ranking from 0 (no fold) to 6 (two severe folds) for each deployment was used as the measure of folding observed.
RESULTS: Of the 37 cases, cumulative mean ± standard deviation fold ranking for stent grafts oversized >30% (n = 5) was significantly greater than the rest (3.4 ± 1.7 vs 0.5 ± 1.2, respectively; Mann-Whitney U test; P < .005). When barb length was varied from 2 to 7 mm (oversizing held at 10%-20%), folding was noted in one of 11 cases. Similarly, when barb angle was varied from 0° (vertical) to 90° (horizontal), folding was not noted in any of the seven cases. The pullout force was not significantly different between stent grafts with and without folding (5.4 ± 1.95 vs 5.12 ± 1.89 N, respectively; P > .5). At least one instance of folding was noted in the seven of seven (100%) stent grafts with oversizing >23.5% and in only five of 30 (14%) stent grafts with oversizing <23.5%.
CONCLUSIONS: Stent graft folding was prevalent when oversized >30%. Large variations in barb length and angle did not aggravate folding risk when oversized within the recommended range of 10% to 20%.
Authors:
Kathleen K Lin; Jarin A Kratzberg; Madhavan L Raghavan
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-02-02
Journal Detail:
Title:  Journal of vascular surgery     Volume:  55     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-30     Completed Date:  2012-06-20     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1401-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa 52242-1527, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aorta, Thoracic / radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*
Cattle
Computer Simulation
Endoleak / etiology
Endovascular Procedures / adverse effects,  instrumentation*
Finite Element Analysis
Foreign-Body Migration / etiology
Models, Cardiovascular
Prosthesis Design
Risk Assessment
Risk Factors
Stents*
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
R15 HL087642/HL/NHLBI NIH HHS; R15 HL087642-01/HL/NHLBI NIH HHS
Comments/Corrections

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