A proof-of-concept in vitro study to determine if EndoAnchors can reduce gutter size in chimney graft configurations

摘要

Purpose: To investigate the feasibility of using endoanchor technology to reduce chimney graft-related gutter size in a juxtarenal aneurysm model. Methods: In silicone juxtarenal aortic aneurysm models with two sizes of branch arteries and two sizes of aorta, single chimney graft (CG) configurations were constructed using 6-mm Atrium balloon-expandable stent-grafts in association with two sizes of Gore Excluder main grafts (23 and 28.5 mm). Configurations without Aptus EndoAnchors, with suprarenal placement of EndoAnchors, and with additional infrarenal placement of EndoAnchors were investigated. A total of 12 CG configurations were scanned using 64-slice computed tomography. Gutter volume and gutter areas at the top and bottom of the sealing zone were measured with image processing software. Results: The combination of supra- and infrarenal placement of endoanchors led to a reduction in gutter volume compared to unanchored configurations. The same configurations also led to a decrease in gutter area at the bottom of the sealing zone. Conclusion: It is feasible to reduce gutters in CG configurations with the use of endoanchors in an in vitro juxtarenal aneurysm model.