REDUCTION OF ANEURYSM PRESSURE AND WALL STRESS AFTER ENDOVASCULAR REPAIR OF ABDOMINAL AORTIC-ANEURYSM IN A CANINE MODEL

A canine model was designed to evaluate the changes in abdominal aorti c aneurysm (AAA) pressure and wall stress after endovascular repair. E ight canines underwent laparotomy and creation of an AAA. The aneurysm was then excluded with a transluminally placed endovascular graft (TP EG) inserted through the right femoral artery and deployed across the AAA to exclude the infrarenal aortic branches from aortic perfusion. B lood pressure and flow data were recorded for 6 hours. The AAA blood p ressure decreased from 135 +/- 9.3 mm Hg before exclusion to 45 +/- 17 .6 mm Hg at 10 minutes after exclusion do < 0.001). At 6 hours, AAA bl ood pressure had declined further to 26 +/- 12.5 mm Hg. Blood Row in t he excluded iliac artery decreased from a baseline of 242 +/- 58 ml/mi n to 41 +/- 29 ml/min 10 minutes after TPEG placement (p < 0.001). At 6 hours, flow was reduced to 12 +/- 3.5 ml/min (p < 0.05 compared with that at 10 minutes). Aortic wall stress was significantly reduced by TPEG placement but was only slightly lower than baseline aortic wall s tress before AAA creation. The lumbar arteries were patent with retrog rade Row in all cases and were found to be the major contributors to p ostexclusion aneurysm pressure. Endovascular AAA exclusion results in an immediate decrease in blood pressure and wall stress within the exc luded aneurysm, but the aneurysm remains perfused by retrograde Row th rough the lumbar arteries, which resulted in near-baseline levels of a neurysm wall stress in this canine model. Embolization of patent lumba r vessels at prosthesis placement may further reduce the risk of late rupture.