The Perth endoluminal bifurcated graft system--development and early experience

Area of Science:

• Vascular Surgery
• Biomedical Engineering
• Medical Device Development

Background:

• Abdominal aortic aneurysms (AAAs) pose significant risks, necessitating effective treatment options.
• Endovascular aneurysm repair (EVAR) offers a less invasive approach but requires specialized graft systems.
• Developing reliable bifurcated grafts is crucial for expanding EVAR applicability to complex anatomies.

Purpose of the Study:

• To develop and evaluate a novel, reliable endoluminal bifurcated graft system for treating infrarenal abdominal aortic aneurysms.
• To assess the feasibility and efficacy of this new graft system in a patient cohort.

Main Methods:

• A life-size model of the aorta and iliac arteries was used for developing a bifurcated graft system.
• The system utilized self-expanding Gianturco and 'Z' stents within a Dacron graft.
• Deployment involved a novel technique using both femoral arteries for a bifurcated and extended straight graft placement.

Main Results:

• The bifurcated graft system was deployed in 21 patients, achieving satisfactory aneurysm exclusion in 17 (81%).
• Median follow-up of 30 weeks showed sustained aneurysm exclusion in successfully treated patients.
• No renal artery complications were observed despite stent placement across renal artery origins in 85% of cases.

Conclusions:

• The developed bifurcated endoluminal graft system is a viable option for treating infrarenal abdominal aortic aneurysms.
• This system demonstrates promising results in terms of aneurysm exclusion and safety.
• The ability to deploy a bifurcated system expands the potential for endovascular treatment of AAAs.