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Endovascular graft placement in experimental dissection of the thoracic aorta
F Boudghène1, M Sapoval, J M Bigot
1Department of Radiology, Hopital Tenon, Paris, France.
Purpose:
To test the effectiveness of endoluminal exclusion of the false lumen in experimental thoracic aortic dissection by occlusion of the entry site with a balloon-expandable endograft.
Materials And Methods:
Thoracic aortic dissections were induced surgically in six beagles. The endograft consisted of an ultrathin, 12-mm-wide polyester tube sutured over a Strecker stent that was already crimped onto an angioplasty balloon. Fluoroscopic and intravascular ultrasonographic (IVUS) guidance were used. Endografts were introduced by means of femoral arteriotomy, via a 12-F sheath positioned in the aorta, and were then expanded on the angioplasty catheter.
Results:
IVUS and aortography showed an extensive thoracic dissection in all animals. Only four of six endografts were successfully placed. At 1 month, all thoracic endografts were patent, but the false lumen was never thrombosed. IVUS scans demonstrated a malpositioned endograft in two cases and persistent reentry in all cases.
Conclusion:
Endovascular grafting of the aorta was feasible in experimental thoracic aortic dissection, but thrombosis of the false lumen was not achieved.