Chronic intraaneurysmal pressure measurement: an experimental method for evaluating the effectiveness of endovascular aortic aneurysm exclusion

J Vasc Surg. 1997 Aug;26(2):222-30. doi: 10.1016/s0741-5214(97)70182-4.

Abstract

Purpose: To evaluate and compare the intraaneurysmal pressure (IAP) after exclusion using two different endovascular grafts.

Methods: Eight mongrel dogs had a 3 x 3 cm polytetrafluoroethylene (PTFE) aneurysm sewn as an interposition graft of the infrarenal aorta. A pressure transducer implanted into the aneurysm wall permitted continuous electronic IAP monitoring. Four aneurysms were excluded with a transluminally placed endovascular graft made of a PTFE graft and two Palmaz stents (PTFE-EG), three were excluded with a tantalum-Dacron endovascular graft (TD-EG), and one was surgically treated with a standard PTFE graft (PTFE-Surg). The dogs were observed for 18 to 50 days (mean, 37.5 days) and were evaluated after surgery with duplex and spiral computed tomographic scans.

Results: All grafts successfully excluded the aneurysms without perigraft channels or leaks as documented by arteriogram and duplex and computed tomographic scans. The mean IAPs after repair with all PTFE-EGs were significantly lower (p < 0.001) than the mean systemic pressures. In addition, the mean IAP reduction was significantly greater (p < 0.005) in the PTFE-EG group than in the TD-EG group.

Conclusions: Aneurysm exclusion with PTFE-EG significantly lowered IAP, did so significantly better than the TD-EG, and approached the IAP reduction obtained by standard repair. Such pressure reduction is necessary for effective protection against aneurysm rupture.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / physiopathology*
  • Aortic Aneurysm / surgery
  • Blood Pressure Determination* / instrumentation
  • Blood Pressure Determination* / methods
  • Blood Vessel Prosthesis / methods*
  • Disease Models, Animal
  • Dogs
  • Polyethylene Terephthalates
  • Polytetrafluoroethylene
  • Tantalum
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography

Substances

  • Polyethylene Terephthalates
  • Tantalum
  • Polytetrafluoroethylene