European Journal of Vascular & Endovascular Surgery
Volume 37, Issue 6 , Pages 671-680, June 2009

A Study of Pullout Forces of the Components of Modular Multi-manufacturer Hybrid Endografts Used for Aortic Aneurysm Repair

  • D.P. Cinà

      Affiliations

    • Division of Vascular and Endovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • ,
  • G. Grant

      Affiliations

    • Division of Vascular and Endovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • ,
  • M. Peterson

      Affiliations

    • Division of Cardiac Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • ,
  • V. Campbell

      Affiliations

    • Division of Vascular and Endovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • ,
  • L. Garrido-Olivares

      Affiliations

    • Division of Vascular and Endovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • ,
  • C.S. Cinà

      Affiliations

    • Division of Vascular and Endovascular Surgery, St Michael's Hospital, University of Toronto, Toronto, ON, Canada
    • Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
    • Corresponding Author InformationCorresponding author. C.S. Cinà, Division of Vascular and Endovascular Surgery, St Michael's Hospital, 55 Queen St. East, Suite 308, University of Toronto, Toronto, Ontario M5C 1R6, Canada. Tel.: +1 416 864 5288; fax: +1 416 864 5768.

Received 9 February 2009; accepted 20 February 2009. published online 31 March 2009.

Abstract 

Objectives

Aorto-iliac angulations may be challenging for modular stent-graft systems (SGSs) from a single manufacturer. This study aims to define the pullout forces (POFs) of SGSs derived from the same (non-hybrid) or different manufacturers (hybrid).

Methods

The POFs were tested in a vertical position in air and 5% albumin. We studied the POFs between legs from Anaconda (Vascutek®), Excluder (Gore®), Talent (Medtronic®) and Zenith (Cook®) with the contralateral limb of bifurcated aortic bodies from Zenith (12mm), Anaconda and Excluder.

Results

For non-hybrid SGSs, the POFs decreased in the following order: Anaconda (11.2±0.6N), Talent (6.25±0.6N), Zenith (3.5±0.01N) and Excluder (2.5±0.5N). The Zenith body with the Anaconda limb (15mm) registered the greatest POF (13.083±0.821N); the Zenith and Excluder bodies combined with the Excluder limb (16mm) registered the weakest POFs (2.397±0.22N and 2.500±0.479N, respectively). The Zenith body combined with the Excluder limb (16mm) had a POF similar to the Zenith non-hybrid; combined with Talent 14mm and Anaconda limb exhibited POFs greater than the Zenith non-hybrid system. For the limb-to-limb POFs, the greatest was registered for the Anaconda limb, 13mm within a 12-mm extension for 40-mm overlaps (23.06±0.480N); the weakest POFs were recorded for the Excluder limbs at 30-mm overlaps (1.09±0.167N and 1.11±0.250N).

Conclusions

The hybrid SGSs performed as well as or better than the non-hybrid systems, and should be considered for clinical testing in patients whose unique anatomy warrants the flexibility that the use of hybrids provides.

Keywords: Endovascular aneurysm repair, Endografts, Endostents

 

PII: S1078-5884(09)00125-7

doi:10.1016/j.ejvs.2009.02.017

European Journal of Vascular & Endovascular Surgery
Volume 37, Issue 6 , Pages 671-680, June 2009

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