The Impact of Hypovolaemic Shock on the Aortic Diameter in a Porcine Model

Aortic diameters during lowering of the blood volume. Error bars represent the 95% confidence interval of the mean.

Descending thoracic aortic diameter in all subjects during blood loss. The lines represent the individual descending thoracic aortic diameter of the seven subjects during lowering of the blood volume.

Increase of the ascending and abdominal aortic diameter during resuscitation. The descending thoracic aorta was not included in this figure because the stent graft was deployed in the descending thoracic aorta, and from that moment the diameter measured by IVUS actually represents the stent lumen. Error bars represent the 95% confidence interval of the mean.

IVUS images of a type 1 endoleak after complete resuscitation A. In this subject, the descending thoracic aortic diameter decreased from 15.5 to 7.4 mm (52.3%) after 40% blood loss, and a 12 mm stent graft was deployed (62% oversizing). Black arrow: stent graft; white arrow: aortic wall. B. The same subject after complete fluid resuscitation. A large endoleak (yellow arrow) is visible between the stent graft (black arrow) and the aortic wall (white arrow). The leakage was already detected after 20% fluid resuscitation, and further increased during continued resuscitation.

Descending thoracic aorta and proximal stent graft at autopsy No abnormalities were found during autopsy, the stent grafts were adequately deployed in the descending thoracic aorta, and no stent enfolding was observed.

Descending thoracic aortic diameter and theoretic oversizing of the endograft-related to circulating blood volume The red line represents the theoretic percentage of oversizing of the aortic diameter to obtain a 15% oversizing of the normal aortic diameter, which is recommended by most endograft manufacturers. Error bars represent the 95% confidence interval of the mean.