Dm. Williams et al., CANINE MODEL OF ACUTE AORTIC RUPTURE - TREATMENT WITH PERCUTANEOUS DELIVERY OF A COVERED Z-STENT - WORK-IN-PROGRESS, Journal of vascular and interventional radiology, 5(6), 1994, pp. 797-803
PURPOSE: To develop a percutaneous treatment for aortic rupture with u
se of a covered intraluminal stent. MATERIALS AND METHODS: A transmura
l tear was created percutaneously in the thoracic aorta in six dogs wi
th use of a 4-mm angioplasty balloon, Gianturco Z stents were covered
with polytetrafluoroethylene, loaded into a 14-F sheath, and advanced
through the femoral artery to the site of injury. Within 2 minutes aft
er initiation of the injury, the stent was deployed, Homologous canine
blood was given during the procedure, Dogs that survived 24 hours wer
e then killed.RESULTS: The first stent did not expand completely, and
the dog died in 1 hour, At necropsy, the first two dogs (1-hour and 8-
hour survival) had a large left hemothorax and extensive periaortic he
matoma, indicating intrathoracic exsanguination. The next four dogs we
re treated with a modified stent and survived 2 hours (n = 1), 8 hours
(n = 1), and 24 hours (n = 2), At necropsy hemothorax did not exceed
15 mL, and periaortic hematomas were small. The cause of death in the
two early casualties with the modified stent is uncertain, There were
no signs of spinal cord injury despite occlusion of three pairs of int
ercostal arteries. CONCLUSION: The covered Z stent (in its modified fo
rm) tamponaded the aortic tear, preventing exsanguination. Long-term s
tudies of biocompatibility of this device appear justified.