Aneurysm Pulsatility After Endovascular Exclusion - An Experimental Study Using Human Aortic Aneurysms

• Published in: Clinics (São Paulo, Brazil) Brazil), 2008-02, Vol.63 (1), p.67-70
• Main Authors: Orra, Hussein Amin, Puech-Leão, Pedro, Silva, Erasmo Simão da, Silva, Domingos Guerino
• Format: Article
• Language: English
• Subjects: abdominal; Aorta; Aortic Aneurysm, Abdominal - physiopathology; Aortic Aneurysm, Abdominal - surgery; Aortic neurysm; Basic Research; Blood Vessel Prosthesis Implantation; Cadaver; Endoluminal repair; Humans; MEDICINE, GENERAL & INTERNAL; Pulsatile flow; Pulsatile Flow - physiology; Vascular surgery
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.1590/S1807-59322008000100012

To measure the pulsatility of human aneurysms before and after complete exclusion with an endograft. Five aortic aneurysms obtained during necropsy were submitted to pulsatile perfusion before and after implantation of a bifurcated endograft. The specimens were contained in a closed chamber filled with saline solution. A vertical tube attached to the chamber was used to measure volume dislocation in each systole. Mural thrombus was kept intact, and the space around the device was filled with human blood. After each experiment, the aneurysm was opened to check for the correct positioning and attachment of the device. The level of the saline column oscillated during pulsation in each case, with respective amplitudes of 17, 16, 13, 7, and 25 cm before the endograft insertion. After the insertion, the amplitudes dropped to 13, 12, 9, 3.5, and 23 cm, respectively. The differences were not significant. During the post-experimental examination, all devices were found to be in position and well attached to the neck and iliacs. No endoleak was detected during perfusion or by visual inspection. Pulsation of an endograft is transmitted to the aneurysm wall even in the absence of endoleak, and should not be interpreted as procedural failure.