Endovascular healing is inadequate for fixation of Dacron stent-grafts in human aortoiliac vessels

Research output: Contribution to journalArticle

Abstract

BACKGROUND: migration and kinking of stent-grafts can occur late after endovascular aneurysm repair. It is unknown if endovascular grafts incorporate enough to be permanently anchored. In this report, healing of aortic stent-grafts was assessed in humans. PATIENTS AND METHODS: we retrieved 23 Dacron stent-grafts from patients treated for an aortic aneurysm since 1993. Twelve stent-grafts were explanted at late conversion to open repair and 11 at autopsy. The deaths were unrelated to graft fixation. The median age of the patients was 74 years (IQR 55-84 years) and the grafts were explanted 9 months (1-31 months) after insertion. Microscopic slides were prepared by conventional techniques or by cutting and grinding arterial specimens embedded in plastic with the stent-grafts in situ. RESULTS: the stent-grafts detached readily from the native arteries at surgery or autopsy, except when the stents had hooks or barbs which engaged the vessel wall. A space filled with poorly organised blood components persisted between the graft and the aortic wall 2.5 years after implantation. No firm incorporation of the grafts was observed proximally in the aneurysm neck or distally in the iliac segment. A friable neo-intimal layer covered parts of the luminal aspect of the grafts. CONCLUSIONS: endovascular healing provides poor fixation of Dacron stent-grafts in humans. At present, fixation relies on the mechanical properties of the stent-grafts.

Details

Authors
  • Martin Malina
  • J Brunkwall
  • Krassi Ivancev
  • J Jonsson
  • J Malina
  • Bengt Lindblad
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Surgery

Keywords

  • Endovascular graft, Aortic aneurysm repair, Stent-graft, Healing, Dacron, Migration
Original languageEnglish
Pages (from-to)5-11
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume19
Issue number1
Publication statusPublished - 2000
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Unit for Clinical Vascular Disease Research (013242410), Emergency medicine/Medicine/Surgery (013240200), Medical Radiology Unit (013241410), Pathology (Malmö) (013031000)