TY - JOUR
T1 - Histologic Analysis with the Newly Designed Exoskeleton Seal® Stent-Graft in the Porcine Abdominal Aorta
AU - Park, Jung Hoon
AU - Cho, Young Kwon
AU - Her, Keun
AU - Jeon, Yong Sun
AU - Kim, Jeong Ho
AU - Seo, Tae Seok
AU - Song, Myung Gyu
N1 - Funding Information:
Funding The study was supported by a Grant No. 2018-10 from the Kangdong Sacred Heart Hospital Fund.
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
PY - 2019/9/15
Y1 - 2019/9/15
N2 - 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.
AB - 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.
KW - Animal studies
KW - Exoskeleton stent-graft
KW - Neointimal hyperplasia
KW - Porcine abdominal aorta
KW - Thrombotic occlusions
UR - http://www.scopus.com/inward/record.url?scp=85067690895&partnerID=8YFLogxK
U2 - 10.1007/s00270-019-02261-2
DO - 10.1007/s00270-019-02261-2
M3 - Article
C2 - 31201508
AN - SCOPUS:85067690895
SN - 0174-1551
VL - 42
SP - 1331
EP - 1342
JO - CardioVascular and Interventional Radiology
JF - CardioVascular and Interventional Radiology
IS - 9
ER -