Mechanical and clinical evaluation of home made abdominal aortic endograft
Identifieur interne : 000377 ( Main/Exploration ); précédent : 000376; suivant : 000378Mechanical and clinical evaluation of home made abdominal aortic endograft
Auteurs : Jean-Dominique Singland [France]Source :
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Abstract
By conception, the home made endograft (HME) designed by the surgeon suits the size of near 80% of abdominal aortic aneurysms (AAA). This percentage is better than the one of commercial endografts with a given size. We present the results of both mechanical and clinical studies of HME designed and made at the Pitié-Salpétrière Hospital (Paris) from Gianturco Z stents and a woven polyester graft (Twillweave, Vascutek). The sizing is made by cutting and suturing the graft. The study was carried out in order to answer to the query requirements of the AFSSAPS. The static tests showed that the stresses imposed on the HME during the implantation were below those that are able to degrade its components. Besides, to know the dynamical stresses applied to HME, we measured in vivo displacements inside its structure by using a dynamic tomodensitometry and a model of the HME. 11 patients were included in the study. Maximal angular and radial displacements were respectively 4.5° and 4.2% at the junction of the neck and the body of the HME. The measured radial displacements were taken as the boundary conditions in the dynamical test we are carrying out. The HME is exposed to physiological variations of the pressure produced by an electrodynamic engine at a frequency of 15 Hz for a test of 400 millions of cycles (equivalent to 10 years of implantation). The animal implantation in the aorta of 6 sheep during 6 months showed the good compatibility and integration of the HME. Finally, a retrospective clinical study over 11 years showed the efficiency of the HME with a decrease of 27% of the diameter of the AAA in a population of near 500 patients without any mechanical failure.
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This percentage is better than the one of commercial endografts with a given size. We present the results of both mechanical and clinical studies of HME designed and made at the Pitié-Salpétrière Hospital (Paris) from Gianturco Z stents and a woven polyester graft (Twillweave, Vascutek). The sizing is made by cutting and suturing the graft. The study was carried out in order to answer to the query requirements of the AFSSAPS. The static tests showed that the stresses imposed on the HME during the implantation were below those that are able to degrade its components. Besides, to know the dynamical stresses applied to HME, we measured in vivo displacements inside its structure by using a dynamic tomodensitometry and a model of the HME. 11 patients were included in the study. Maximal angular and radial displacements were respectively 4.5° and 4.2% at the junction of the neck and the body of the HME. The measured radial displacements were taken as the boundary conditions in the dynamical test we are carrying out. The HME is exposed to physiological variations of the pressure produced by an electrodynamic engine at a frequency of 15 Hz for a test of 400 millions of cycles (equivalent to 10 years of implantation). The animal implantation in the aorta of 6 sheep during 6 months showed the good compatibility and integration of the HME. Finally, a retrospective clinical study over 11 years showed the efficiency of the HME with a decrease of 27% of the diameter of the AAA in a population of near 500 patients without any mechanical failure.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement><orgName><li>Université Paris 13</li></orgName></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Singland, Jean Dominique" sort="Singland, Jean Dominique" uniqKey="Singland J" first="Jean-Dominique" last="Singland">Jean-Dominique Singland</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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