Abdominal aortic aneurysm repair via percutaneous endovascular stenting in the swine model

Abdominal aortic aneurysms (AAAs) are the 13th leading cause of death in the United States. Endovascular stent grafts are currently being investigated in clinical trials as an alternative method for treatment of AAA. Twelve pigs underwent creation of AAA using the abdominus rectus fascia. Postoperatively, all 12 animals underwent angiography, which demonstrated turbulent flow within the created aneurysms. Four of the animals were not stented and served as controls. Eight animals underwent subsequent percutaneous placement of a covered endovascular stent via a right femoral sheath, and the stents were deployed between the renal arteries and the aortic bifurcation. The animals were maintained for 120 days before sacrifice and necropsy. Unstented animals (4) died within 6 days, 3 from rupture. Eight animals underwent endovascular stenting: 5 survived without complications, 3 deaths within 2 days were related to technical complications. The 5 surviving animals were sacrificed at 120 days, and necropsy was conducted with in situ dissections of the aorta and intact stent: 3 experimental animals had correct anatomic positioning of the stent, and 2 had inexact stent placement but survived 120 days with AAA thrombosis. Treatment of AAA in this swine model has been demonstrated via placement of a percutaneous covered stent.