Key result
Internal shunting and iliac transposition prevent spinal ischemia in ovine AAA models with ~94% survival.
Why the study?
Does the use of an internal aortic shunt and iliac bypass prevent spinal cord ischemia in an ovine model of abdominal aortic aneurysm treated with stent-grafts?
Does the use of an internal aortic shunt and iliac bypass prevent spinal cord ischemia in an ovine model of abdominal aortic aneurysm treated with stent-grafts?
The use of an internal shunt and iliac bypass successfully prevents spinal cord ischemia during experimental AAA creation and stent-graft deployment in an ovine model.
Provides preclinical proof-of-concept for spinal protection in endovascular AAA repair; leaves open translation to clinical practice.
Purpose: To present novel techniques to prevent spinal ischemia during aneurysm creation and chronic bifurcated stent-graft implantation in an ovine model of abdominal aortic aneurysm (AAA). Method: Experimental AAAs were created in 38 sheep. To prevent spinal ischemia, an internal aortic shunt was used during aneurysm creation. In the animals designated to receive bifurcated stent-grafts, a left external iliac-to-internal iliac bypass was performed to revascularize the caudal artery and prevent postdeployment spinal cord ischemia. Specimens were harvested at 1 week, 1, 3, and 6 months, and 1 year. Results: Aneurysms were successfully created without paralysis in 35 animals. Two died due to aspiration pneumonia. Of the 33 animals implanted with endografts, 16 (94%) of 17 with straight devices and 15 (94%) of 16 with bifurcated stent-grafts survived with well-functioning, patent stent-grafts. Paralysis developed in 2 animals after endografting due to technical failures. Conclusions: The use of an internal shunt during aneurysm creation and internal iliac-to-external iliac transposition prior to bifurcated stent-graft deployment prevented spinal ischemia in an ovine AAA model. Chronically deployed stent-grafts were well tolerated.
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Beygui et al. (1999) studied Abdominal aortic aneurysm (ovine model) (n=38). Internal aortic shunt and left external iliac-to-internal iliac bypass was evaluated on Prevention of spinal ischemia and survival with patent stent-grafts. The use of an internal shunt and internal iliac-to-external iliac transposition prevented spinal ischemia in an ovine AAA model, with 94% of animals surviving with patent stent-grafts.
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