Geometric Study of Various Chimney Graft Configurations in an In Vitro Juxtarenal Aneurysm Model.
de Bruin, Jorg L. MD 1,*; Yeung, Kak K. MD 1,3,*; Niepoth, Wouter W. BSc 1; Lely, Rutger J. MD 2; Cheung, Qingfeng BSc 1; Vries, Anesh de BSc 1; Blankensteijn, Jan D. MD, PhD 1
[Miscellaneous Article]
Journal of Endovascular Therapy.
20(2):184-190, April 2013.
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Purpose: To determine gutter size and stent-graft geometry in an in vitro juxtarenal aneurysm model using various chimney graft (CG) configurations.
Methods: Two silicone juxtarenal aortic aneurysm models were constructed combining different diameters of the aorta and renal artery. In a single-branched CG configuration, 2 sizes (23 and 28.5 mm) of Excluder stent-grafts were tested individually with 2 sizes of 2 types of CGs: Advanta balloon-expandable (BE) stent-grafts (6x59 and 12x61 mm) and Viabahn self-expanding (SE) stent-grafts (6x50 and 13x50 mm). All combinations were tested with a short (10-mm) and long (20-mm) sealing zone between the CG and main graft (total 16 configurations). Immediately after deployment, the CG configuration was scanned using a 64-slice computed tomography scanner. Gutter sizes were measured at different levels of the sealing zone.
Results: At the top of the sealing zone, the gutters were significantly larger in the BE CGs compared to SE CGs in combination with the 23-mm main graft (p=0.021). At the bottom of the sealing zone, there were no statistically significant differences (p=0.77). No significant differences were seen using the 28.5-mm main graft. Median gutter size was larger in the 6-mm CGs. The length of the sealing zone had no influence on gutter size. Significant compression of the main graft was found using 12 or 13-mm CGs compared to 6-mm CGs (p=0.001).
Conclusion: In this in vitro study, the CG configurations with BE stent-grafts show larger gutters than configurations with SE stent-grafts in small main grafts. Main graft compression is increased using wider CG stent-grafts.
(C) 2013 Allen Press