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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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The inside-out endograft: a proposed method to decrease the profile of aortic stent-grafts.

Andrew Kerr1

  • 1Department of Radiology, New York Medical College-Metropolitan Hospital New York, New York 10029, USA. Andrew.Kerra@nychhc.org

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|December 10, 2009
PubMed
Summary
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Reducing endograft profile is possible by connecting components without overlap and using an inside-out deployment technique. This method effectively decreases the introducer size for aortic endografts.

Area of Science:

  • Vascular Surgery
  • Biomedical Engineering
  • Medical Device Design

Background:

  • Endograft introducer profile is a critical factor in endovascular aortic repair.
  • Minimizing the introducer sheath size can reduce surgical trauma and improve patient outcomes.

Purpose of the Study:

  • To investigate if non-overlapping endograft components reduce the device profile.
  • To evaluate the feasibility of an inside-out deployment technique for aortic endografts.

Main Methods:

  • An endograft with end-to-end component connection (no overlap) was designed and tested.
  • A water flow model simulated the deployment and layer formation.
  • A Zenith endograft was modified and deployed using the inside-out technique.

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Main Results:

  • The endograft components formed overlapping layers upon release in the flow model.
  • The inside-out deployment technique successfully reduced the introducer size of a modified Zenith endograft from 20 to 14 French.

Conclusions:

  • Combining inside-out deployment with end-to-end component connection is a promising strategy.
  • This approach may effectively decrease the entry profile of aortic endografts.
  • Further studies are warranted to validate clinical efficacy.