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

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

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)1331-1342
Number of pages12
JournalCardioVascular and Interventional Radiology
Issue number9
Publication statusPublished - 2019 Sept 15

Bibliographical note

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).


  • Animal studies
  • Exoskeleton stent-graft
  • Neointimal hyperplasia
  • Porcine abdominal aorta
  • Thrombotic occlusions

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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