Slim graft: a low-profile method for deploying endovascular grafts

The inside-out endograft: a proposed method to decrease the profile of aortic stent-grafts

PURPOSE

To test the novel hypotheses that (1) endograft profile can be reduced if the components do not overlap in the carrier catheter and (2) the inside-out deployment technique can produce a device with overlapping layers.

TECHNIQUE

This study evaluated an endograft in which the graft and stents were connected to each other in an end-to-end fashion without overlap. The endograft was released into a water flow model to become overlapping layers of graft and stents. Then, a Zenith endograft was modified and deployed using this technique, which reduced the Zenith endograft introducer from 20 to 14 French.

CONCLUSION

Inside-out endograft deployment combined with the end-to-end connection of components without overlap may be an effective method to decrease the entry profile of aortic endografts.

Aortic Slimgraft: ex vivo and in vivo study

In this article we describe a method for assembling an endovascular graft within the aorta with a graft and then a stent introduced sequentially over a guidewire as separate components. In the ex vivo study, an endovascular graft that was 25 mm in diameter was introduced through a 9F introducer. In the in vivo study, smaller endovascular grafts were placed in the aortas of four healthy pigs and five pigs with aortic aneurysms. Our data suggest that this very low profile system may have significant clinical implications because it converts aortic repair into a percutaneous procedure.

Slimgraft: a percutaneous endovascular graft system

PURPOSE

To describe an in vitro feasibility trial of a new percutaneous endograft delivery technique.

METHODS AND RESULTS

A water flow model of 9-mm (inner diameter) transparent plastic tubing was used to test the feasibility of sequentially delivering the components of an endograft through a 7-F sheath for assembly in situ. The tubular endovascular graft was fabricated from a 10-mm x 68-mm Wallstent and 50-microm-thick Dacron graft. The graft material was formed into a tube, attached with a suture to a guidewire, and delivered into the plastic tubing. The Wallstent was then delivered through the tubular graft and deployed, affixing the graft to the plastic tube wall. In 4 trials, only 1 attempt was not successful.

CONCLUSIONS

These concepts and techniques may have implications in the development of percutaneously deliverable endovascular grafts.