Ra. White et al., DEPLOYMENT TECHNIQUE AND HISTOPATHOLOGICAL EVALUATION OF AN ENDOLUMINAL VASCULAR PROSTHESIS USED TO REPAIR AN ILIAC ARTERY ANEURYSM, Journal of endovascular surgery, 3(3), 1996, pp. 262-269
Citations number
10
Categorie Soggetti
Surgery,"Peripheal Vascular Diseas","Cardiac & Cardiovascular System
Purpose:To describe the deployment technique function, and gross heali
ng of an endoluminal vascular prosthesis deployed in a high-risk patie
nt for treatment of a common iliac artery (CIA) aneurysm. Methods: An
82-year-old, high-risk male with a Gem-diameter CIA aneurysm approxima
tely 4.5 to 5 cm long was treated with endoluminal exclusion of the le
sion using a 6-cm-long, 14-mm-internal diameter Dacron vascular prosth
esis with Palmaz 308 stents sutured to either end of the graft. Intrav
ascular ultrasound (IVUS) imaging facilitated sizing of the endograft
and its accurate positioning so as to occlude both the aneurysm and th
e hypogastric artery, which was a potential source of retrograde flow
to the aneurysm. Exclusion of the lesion and occlusion of the hypogast
ric artery were demonstrated on delayed angiographic images and contra
st computed tomography scans obtained at 16 days postprocedure. Unfort
unately, the patient died 67 days following implantation from a nonpro
cedure-related gastrointestinal complication. Results: At autopsy, the
aortoiliac segment was excised and examined grossly and histologicall
y; the evaluation confirmed complete isolation of the aneurysm by the
fully expanded endoluminal prosthesis. The surface of the vascular gra
ft was covered by a glistening, thin, fibrinous membrane. The graft ma
terial was filled with hypocellular compact fibrinous material with no
evidence of endothelialization. These observations confirm preliminar
y sealing and isolation of the iliac artery aneurysm as healing of the
endograft progressed. Conclusions: The data acquired from the analysi
s of this specimen provide information regarding the utility and early
healing of an endograft used for iliac artery aneurysm exclusion. Thi
s case also exemplifies the utility of IVUS in endograft deployment.