A SELF-EXPANDING BIFURCATED ENDOVASCULAR GRAFT FOR ABDOMINAL AORTIC-ANEURYSM REPAIR - AN INITIAL STUDY IN A CANINE MODEL

Approximately 50,000 abdominal aortic aneurysms (AAAs) are surgically repaired annually in the United States. Endovascular grafts (EVGs) com bine a stent and a vascular graft offering great potential for reduced morbidity, mortality, and hospital stay because of minimally invasive endoluminal placement through catheters. Because most AAAs extend int o one or both iliac arteries, a bifurcated EVG (bEVG) was developed, c onsisting of a proximal aortic trunk divided into two distinct lumens or sockets to receive two smaller diameter leg (iliac) components. All components were composed of Didcott self-expanding braided wire stent s integrally attached to porous spun polycarbonate urethane liners. Su ccessful placement of the bEVGs (trunks 10-12 mm and legs 5-6 mm diame ter) by a 10 Fr introducer through the femoral arteries into the infra renal aorta and external iliac arteries of 9 of 11 dogs was achieved. Subsequently, 11 of 12 bEVGs were successfully placed to exclude a sac cular aneurysm exceeding three aortic diameters created by a fascia la ta pouch extending from the aorta into the left external iliac artery, of which 7 were patent at 1 to 4 months. These findings establish des ign feasibility of the bEVG as well as the utility of the canine exper imental model.