Systematic Review of the Current In Vitro Experience of the Endovascular Treatment of Juxtarenal Abdominal Aortic Aneurysms by Fenestrated and Parallel Endografting

被引:3
|
作者
Taneva, Gergana T. [1 ]
Mirgolbabaee, Hadi [2 ]
Jebbink, Erik Groot [2 ,3 ]
Reijnen, Michel M. P. J. [2 ,3 ]
Donas, Konstantinos P. [1 ]
机构
[1] Goethe Univ Frankfurt, Dept Vasc & Endovasc Surg, Asklepios Clin Langen, Rontgenstr 20, D-63225 Langen, Germany
[2] Univ Twente, Tech Med Ctr, Multimodal Med Imaging M3I Grp, Enschede, Netherlands
[3] Rijnstate Hosp, Dept Surg, Arnhem, Netherlands
关键词
chimney graft; technique; fenestrated stent graft; juxtarenal aneurysm; in vitro model; parallel graft; benchtop model; flow model; endovascular aneurysm repair; fatigue testing; systematic review; STENT-GRAFT; DEVICE FAILURE; RENAL BRANCHES; REPAIR; FLOW; PATHOLOGIES; MIGRATION; SECURE;
D O I
10.1177/15266028221075242
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: To identify and analyze the published in vitro benchtop experiments for the assessment of endovascular techniques used for the treatment of juxtarenal abdominal aortic aneurysms (jAAAs). Data sources: Scopus, PubMed, and Web of Science. Review methods: A systematic literature search was carried out throughout March 2021 following PRISMA guidelines. Two investigators independently performed title and abstract screening to reveal all benchtop testing evaluating the endovascular treatment of jAAA. Results: A total of 19 studies were included, 8 evaluating fenestrated (FEVAR) and 11 parallel grafts (PGs). FEVAR studies used different custom testing apparatus (n=7) or 3D-printed models (n=1) to analyze dislodgement and migration resistance, misalignment consequences and causation, and bridging stents' radial force, flareability, fatigue, and fracture resistance. All PG studies used silicone-based models to analyze optimal oversizing, sealing length, gutter behavior, and possible reduction. Test evaluation in FEVAR in vitro testing was based on pullout force analysis (N=5), photo evaluation (n=1), fluoroscopy (n=1), X-rays (n=4), CT analysis (n=3), macro- and microscopic evaluation (n=4), water permeability (n=1), and fatigue simulator testing (n=1), while it was based on CT analysis in all PG studies adding ECG-gate in one study. The most frequently tested devices were Zenit (Cook) (n=7), Endurant (Medtronic) (n=5), and Excluder (Gore) (n=5) as main grafts, and Advanta V12 (n=14) as the bridging device. Conclusions: This systematic review presents a broad analysis of the current in vitro methods evaluating the endovascular treatment of jAAA. Fundamental issues have been benchtop tested in both FEVAR and PGs. The analysis of the included studies allowed to recommend an optimal testing design. In vitro testing is a potential tool to further elucidate points of attention hard to investigate in vivo to finally enhance the endovascular treatment outcomes. Future in vitro studies are needed to evaluate the in vitro performance of all indistinctively used devices in the clinical practice.
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页码:8 / 17
页数:10
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