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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 2005 October;46(5):485-9

Experimental development of an endovascular graft for thoraco-abdominal aortic aneurysm repair

Di Centa I. 1,2, Coggia M. 1,2, Bonneau M. 3, Goëau-Brissonnière O. 1,2

1 Department of Vascular Surgery Ambroise Paré University Hospital Boulogne-Billancourt,France
2 Faculté de Médecine Paris-Ile de France-Ouest Versailles Saint Quentin en Yvelines University Paris, France
3 Centre de Recherche en Imagerie Interventionnelle CR2I/INRA-APHP, Jouy-en-Josas, France


Aim. Current treatment of thoraco-abdominal aortic aneurysms is surgical. Despite significant advances in surgical technique and anesthetic management, significant morbidity and mortality remain associated with their repair. In compliance with principles of reducing postoperative morbidity, we developed a thoraco-abdominal endovascular graft in experimental models of type III and type IV thoraco-abdominal aortic aneurysm. This device had to preserve the vascularization of the visceral arteries while ensuring full aneurysmal exclusion.
Methods. Six implantations of the endovascular graft were performed. This graft was a modular system, made of: 1) a custom made main body containing 4 prosthetic visceral branches, 2) 4 self-expandable stent-grafts connecting prosthetic visceral branches with visceral arteries, 3) a custom made tubular endovascular graft connecting the main body with one of the iliac arteries.
Results. On angiographic controls, full aneurysmal exclusion was achieved while maintaining visceral artery perfusion. At the end of each procedure, the experimental model was opened. Macroscopic examination showed harmonious thoraco-abdominal endovascular graft deployments, without abnormal component constraint or kinking. There was no discordance between macroscopic and angiographic results.
Conclusion. Our experimental work led to the development of a thoraco-abdominal endovascular graft, demonstrating feasibility of thoraco-abdominal aneurysm endoluminal treatment on an in vitro model close to the anatomical conditions observed in human pathology.

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