Endovascular AAA exclusion: will stents with hooks and barbs prevent stent-graft migration?

Martin Malina, Bengt Lindblad, Krassi Ivancev, Mats Lindh, Janne Malina, Jan Brunkwall

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To investigate if stents with hooks and barbs will improve stent-graft fixation in the abdominal aorta. METHODS: Sixteen- to 24-mm-diameter Dacron grafts were deployed inside cadaveric aortas. The grafts were anchored by stents as in endovascular abdominal aortic aneurysm repair. One hundred thirty-seven stent-graft deployments were carried out with modified self-expanding Z-stents with (A) no hooks and barbs (n = 75), (B) 4 5-mm-long hooks and barbs (n = 39), (C) 8 10-mm-long, strengthened hooks and barbs (n = 19), or (D) hooks only (n = 4). Increasing longitudinal traction was applied to determine the displacement force needed to extract the stent-grafts. The radial force of the stents was measured and correlated to the displacement force. RESULTS: The median (interquartile range) displacement force needed to extract grafts anchored by stent A was 2.5 N (2.0 to 3.4), stent B 7.8 N (7.4 to 10.8), and stent C 22.5 N (17.1 to 27.9), p < 0.001. Both hooks and barbs added anchoring strength. During traction, the weaker barbs were distorted or caused intimal tears. The stronger barbs engaged the entire aortic wall. The radial force of the stents had no impact on fixation, while aortic calcification and graft oversizing had marginal effects. CONCLUSIONS: Stent barbs and hooks increased the fixation of stent-grafts tenfold, while the radial force of stents had no impact. These data may prove important in future endograft development to prevent stent-graft migration after aneurysm exclusion.
Original languageEnglish
Pages (from-to)310-317
JournalJournal of Endovascular Surgery
Volume5
Issue number4
DOIs
Publication statusPublished - 1998

Bibliographical note

The information about affiliations in this record was updated in December 2015.
The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200), Medical Radiology Unit (013241410), Unit for Clinical Vascular Disease Research (013242410)

Subject classification (UKÄ)

  • Clinical Medicine
  • Radiology, Nuclear Medicine and Medical Imaging
  • Cardiac and Cardiovascular Systems

Free keywords

  • endovascular grafting
  • abdominal aortic aneurysm
  • migration
  • Z-stents

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