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Titolo:
All sealed endoleaks are not the same: A treatment strategy based on an ex-vivo analysis
Autore:
Mehta, M; Ohki, T; Veith, FJ; Lipsitz, EC;
Indirizzi:
Montefiore Med Ctr, Div Vasc Surg, Bronx, NY 10467 USA Montefiore Med CtrBronx NY USA 10467 Div Vasc Surg, Bronx, NY 10467 USA Albert Einstein Coll Med, Bronx, NY 10467 USA Albert Einstein Coll Med Bronx NY USA 10467 Coll Med, Bronx, NY 10467 USA
Titolo Testata:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
fascicolo: 6, volume: 21, anno: 2001,
pagine: 541 - 544
SICI:
1078-5884(200106)21:6<541:ASEANT>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
ABDOMINAL AORTIC-ANEURYSMS; ENDOLUMINAL AAA REPAIR; STENT-GRAFT TREATMENT; ENDOVASCULAR REPAIR; CLASSIFICATION; EMBOLIZATION; PRESSURE; LEAKS;
Keywords:
sealed endoleaks;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Ohki, T Montefiore Med Ctr, Div Vasc Surg, 111 E 210th St, Bronx, NY 10467USA Montefiore Med Ctr 111 E 210th St Bronx NY USA 10467 NY 10467 USA
Citazione:
M. Mehta et al., "All sealed endoleaks are not the same: A treatment strategy based on an ex-vivo analysis", EUR J VAS E, 21(6), 2001, pp. 541-544

Abstract

Purpose: factors contributing to pressure transmission through thrombosed or sealed endoleaks have not been elucidated. The purpose of this investigation was to create an ex-vivo model that mimics patent and sealed endoleaksand that can quantitatively analyse the effects of length, diameter and thrombus on pressure transmission to the interior of the aneurysm sac. Methods: in the ex-vivo model, endoleak channels (ELCs) of various lengths(2 cm, 6 cm, 10 cm) and diameters (0.6 cm, 1.0 cm, 1.4 cm) were constructed using polytetrafluoroethylene (PTFE) grafts and attached to an artificialaneurysm sac. These ELCs were incorporated within a mock circulation made of rubber tubing connected to a pulsatile pump. Peak systolic pressure (PSP) was recorded in the aneurysm sac, distal to each ELC. Subsequently the ELCs were filled with human thrombus, and the pressure measurements repeated (n=5). Data was evaluated by regression analysis. Results: peak systolic pressure in the artificial circulation was maintained at 150 mmHg. In the absence of thrombus pressure did not change across the ELC, regardless of its length or diameter. In the presence of organised thrombus, the pressure curves distal to the ELC were dampened, and the pressure reduction was directly proportional to the length and inversely proportional to the diameter of the ELC. Regression analysis indicated statistical significance. Conclusions: in the absence of thrombosis, pressure transmitted via an ELCto the aneurysm sac is unchanged regardless of its length or diameter. Allsealed endoleaks also transmit pressure. However, when an endoleak has thrombosed, pressure reduction is directly proportional to the length and inversely proportional to the diameter of its channel. This ex-vivo model suggests that Type 2 endoleaks with longer channels and smaller diameters would derive a greater benefit from adjunctive manoeuvres (coil embolisation) that hasten thrombosis. On the other hand, thrombosis of endoleaks with short and wide channels (e.g. Type 1) may not result in substantial pressure reduction within the aneurysm sac and a successful outcome.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/03/20 alle ore 22:31:51