1st Department of Surgery, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
Eur J Vasc Endovasc Surg. 2010 Oct;40(4):429-35. doi: 10.1016/j.ejvs.2010.07.007. Epub 2010 Aug 8.
To evaluate the proximal and distal (iliac) fixation of seven self-expanding endografts, used in the endovascular treatment (EVAR) of abdominal-aortic aneurysm (AAA), by measuring the displacement force (DF) necessary to dislocate the devices from their fixation sites.
A total of 20 human cadaveric aortas were exposed, left in situ and transected to serve as fixation zones. The Anaconda, EndoFit aorto-uni-iliac, Endurant, Powerlink, Excluder, Talent and Zenith stent grafts were deployed and caudal force was applied at the flow divider, through a force gauge. The DF needed to dislocate each device ≥ 20 mm from the infrarenal neck was recorded before and after moulding-balloon dilatation. Cephalad force was similarly applied to each iliac limb to assess distal fixation before and after moulding-balloon dilatation.
Endografts with fixation hooks or barbs displayed a significantly higher DF necessary to dislocate the proximal portion compared with devices with no such fixation modalities (p < 0.001). Balloon dilatation produced a significant increase in DF in both devices with (p < 0.001) or without (p = 0.003) hooks or barbs. Suprarenal support did not enhance proximal fixation (p = 0.90). Balloon dilatation significantly increased the DF necessary to dislodge the iliac limbs (p = 0.007).
Devices with fixation hooks displayed higher proximal fixation. Moulding-balloon dilatation increased proximal and distal fixation. Suprarenal support did not affect proximal fixation.
通过测量使装置从固定部位脱位所需的脱位力（DF），评估 7 种用于腹主动脉瘤（AAA）血管内治疗（EVAR）的自膨式内支架的近侧（髂内）和远侧（髂）固定情况。
共暴露 20 个人体尸检主动脉，原位保留并横断以作为固定区域。在 Anaconda、EndoFit 腹主动脉-单-髂动脉、Endurant、Powerlink、Excluder、Talent 和 Zenith 支架移植物部署后，通过测力仪在血流分路器处施加尾向力。记录每个装置从肾下颈脱位≥20mm 所需的 DF，在模压球囊扩张前后。同样向每个髂支施加头向力，以评估模压球囊扩张前后的远侧固定情况。
具有固定钩或倒刺的内支架显示出显著更高的 DF，以将近侧部分脱位，与没有这种固定方式的装置相比（p < 0.001）。球囊扩张导致具有（p < 0.001）或不具有（p = 0.003）钩或倒刺的装置的 DF 均显著增加。肾上极支撑并未增强近端固定（p = 0.90）。球囊扩张显著增加了脱位髂支所需的 DF（p = 0.007）。
具有固定钩的装置显示出更高的近端固定。模压球囊扩张增加了近端和远端的固定。肾上极支撑不影响近端固定。
