Role of aortic stent graft oversizing and barb characteristics on folding

Kathleen K Lin; Jarin A Kratzberg; Madhavan L Raghavan

doi:10.1016/j.jvs.2011.10.080

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Role of aortic stent graft oversizing and barb characteristics on folding

Journal article

Open access

Peer reviewed

Role of aortic stent graft oversizing and barb characteristics on folding

Kathleen K Lin, Jarin A Kratzberg and Madhavan L Raghavan

Journal of vascular surgery, Vol.55(5), pp.1401-1409

05/2012

DOI: 10.1016/j.jvs.2011.10.080

PMCID: PMC3465615

PMID: 22305271

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Abstract

To evaluate folding in infrarenal stent grafts in relation to oversizing, barb angle, and barb length using computed tomography images of stent grafts deployed in explanted bovine aortas. Computed tomography data from an in vitro investigation on the effect of oversizing of 4% to 45% (n = 19), barb length of 2 to 7 mm (n = 11), and barb angle of 10° to 90° (n = 7) on device fixation were examined for instances of folding. Folding was classified as circumferential or longitudinal and quantified on an ordinal scale based on codified criteria. Cumulative fold ranking from 0 (no fold) to 6 (two severe folds) for each deployment was used as the measure of folding observed. Of the 37 cases, cumulative mean ± standard deviation fold ranking for stent grafts oversized >30% (n = 5) was significantly greater than the rest (3.4 ± 1.7 vs 0.5 ± 1.2, respectively; Mann-Whitney U test; P < .005). When barb length was varied from 2 to 7 mm (oversizing held at 10%-20%), folding was noted in one of 11 cases. Similarly, when barb angle was varied from 0° (vertical) to 90° (horizontal), folding was not noted in any of the seven cases. The pullout force was not significantly different between stent grafts with and without folding (5.4 ± 1.95 vs 5.12 ± 1.89 N, respectively; P > .5). At least one instance of folding was noted in the seven of seven (100%) stent grafts with oversizing >23.5% and in only five of 30 (14%) stent grafts with oversizing <23.5%. Stent graft folding was prevalent when oversized >30%. Large variations in barb length and angle did not aggravate folding risk when oversized within the recommended range of 10% to 20%.

Foreign-Body Migration - etiology

Risk Assessment

Models, Cardiovascular

Blood Vessel Prosthesis Implantation - instrumentation

Endovascular Procedures - adverse effects

Risk Factors

Tomography, X-Ray Computed

Blood Vessel Prosthesis

Prosthesis Design

Aortography - methods

Endovascular Procedures - instrumentation

Animals

Aorta, Thoracic - surgery

Blood Vessel Prosthesis Implantation - adverse effects

Cattle

Computer Simulation

Endoleak - etiology

Finite Element Analysis

Stents

Aorta, Thoracic - diagnostic imaging

Details

Title: Subtitle: Role of aortic stent graft oversizing and barb characteristics on folding
Creators: Kathleen K Lin - Department of Biomedical Engineering, University of Iowa, Iowa City, Iowa 52242-1527, USA
Jarin A Kratzberg
Madhavan L Raghavan
Resource Type: Journal article
Publication Details: Journal of vascular surgery, Vol.55(5), pp.1401-1409
DOI: 10.1016/j.jvs.2011.10.080
PMID: 22305271
PMCID: PMC3465615
NLM abbreviation: J Vasc Surg
ISSN: 0741-5214
eISSN: 1097-6809
Publisher: United States
Grant note: R15 HL087642 / NHLBI NIH HHS R15 HL087642-01 / NHLBI NIH HHS
Language: English
Date published: 05/2012
Academic Unit: Roy J. Carver Department of Biomedical Engineering
Record Identifier: 9984064109202771

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