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首页> 外文期刊>Journal of endovascular therapy: an official journal of the International Society of Endovascular Specialists >Effect of Different EndoAnchor Configurations on Aortic Endograft Displacement Resistance: An Experimental Study
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Effect of Different EndoAnchor Configurations on Aortic Endograft Displacement Resistance: An Experimental Study

机译：不同endoanchor配置对主动脉内移植移位抗性的影响：实验研究

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Purpose: This study investigated the effect of different EndoAnchor configurations on aortic endograft displacement resistance in an in vitro model. Materials and Methods: An in vitro model was developed and validated to perform displacement force measurements on different EndoAnchor configurations within an endograft and silicone tube. Five EndoAnchor configurations were created: (1) 6 circumferentially deployed EndoAnchors, (2) 5 EndoAnchors within 120 degrees of the circumference and 1 additional, contralateral EndoAnchor, (3) 4 circumferentially deployed EndoAnchors, (4) 2 rows of 4 circumferentially deployed EndoAnchors, and (5) a configuration of 2 columns of 3 EndoAnchors. An experienced vascular surgeon deployed EndoAnchors under C-arm guidance at the proximal sealing zone of the endograft. A constant force with increments of 1 newton (N) was applied to the distal end of the endograft. The force necessary to displace a part of the endograft by 3 mm was defined as the endograft displacement force (EDF). Two video cameras recorded the measurements. Videos were examined to determine the exact moment 3-mm migration had occurred at part of the endograft. Five measurements were performed after each deployed EndoAnchor for each configuration. Measurements are given as the median and interquartile range (IQR) Q1, Q3. Results: Baseline displacement force measurement of the endograft without EndoAnchors resulted in a median EDF of 5.1 N (IQR 4.8, 5.2). The circumferential distribution of 6 EndoAnchors resulted in a median EDF of 53.7 N (IQR 49.0, 59.0), whereas configurations 2 through 5 demonstrated substantially lower EDFs of 29.0 N (IQR 28.5, 30.1), 24.6 N (IQR 21.9, 27.2), 36.7 N, and 9.6 N (IQR 9.4, 10.0), respectively. Decreasing the distance between the EndoAnchors over the circumference of the endograft increased the displacement resistance. Conclusion: This in vitro study demonstrates the influence EndoAnchor configurations have on the displacement resistance of an aortic endograft. Parts of the endograft where no EndoAnchor has been deployed remain sensitive to migration. In the current model, the only configuration that rivaled a hand-sewn anastomosis was the one with 6 EndoAnchors. A circumferential distribution of EndoAnchors with small distances between EndoAnchors should be pursued, if possible. This study provides a quantification of different EndoAnchor configurations that clinicians may have to adopt in clinical practice, which can help them make a measured decision on where to deploy EndoAnchors to ensure good endograft fixation.
机译：目的：本研究研究了不同endoanchor配置对体外模型中主动脉内移植移位性的影响。材料和方法：开发并验证了体外模型，以对内泌填充物和硅树管内的不同endoanchor构型进行位移力测量。创造了五个内心群配置：（1）6周向展开的内心骨架，（2）5内的圆周120度内的endoanchors，（2）另外，对侧endoanchor，（3）4周向部署的endoanchors，（4）2行的4行围绕的4行，和（5）配置2列的3个endoanchors。经验丰富的血管外科医生在内侵移近侧密封区的C形臂引导下展开了内心。将1牛顿（n）增量的恒定力施加到内侧移植物的远端。将内血血移植物的一部分所需的力定义为内血血移位力（EDF）。两个摄像机记录了测量。检查视频以确定在内切拉移植的一部分发生的确切时刻3 mm迁移。在每个配置的每个配置后，在每个部署的内心支架之后进行五次测量。测量作为中位数和界分范围（IQR）Q1，Q3给出。结果：基线位移力测量内侵扰物没有endoanchors，导致中位数为5.1 n（IQR 4.8,5.2）。 6个endoanchors的圆周分布导致中值EDF（IQR 49.0,59.0），而配置2到5的态度为29.0 n（IQR 28.5,30.1），24.6 n（IQR 21.9,27.2），36.7 n，和9.6 n（IQR 9.4,10.0）。在内切拉移植物的圆周上减小endoanchors之间的距离增加了位移阻力。结论：这种体外研究表明，影响endoanchor构型对主动脉内移植物的位移抗性。没有内诺勒已经部署的内鳍移植物的部分对迁移仍然敏感。在当前的模型中，唯一的配置竞争对手缝合吻合术是具有6个内心的吻合。如果可能，应追求内心距离内侧距离的圆周分布。本研究规定了不同的endoanchor配置的量化，即临床医生可能必须采用临床实践，这可以帮助他们在部署endoanchors以确保良好的内泌生物固定的地方进行测量决定。

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