Comparison of Temporary Open Arterial Revascularization Using Stent Grafts vs. Standard Vascular Shunts in a Porcine (Sus scrofa) Model
Abstract
Objectives: Open surgical reconstruction using expanded polytetrafluoroethylene stent grafts to create a sutureless anastomosis is an alternative to standard temporary vascular shunts. We sought to characterize patency and flow characteristics of these grafts compared to standard shunts in a survival model of porcine vascular injury. Methods: 12 Yorkshire-cross swine received a 2cm long near-circumferential defect in the iliac arteries. A14-French Argyle shunt was inserted into one randomly assigned artery, with a self-expanding ePTFE stent deployed in the other. Arterial flow measurements were obtained at baseline, immediately after intervention, and after 72 hours. Blood pressure proximal and distal to the conduits and arterial samples for histopathology were obtained during the terminal procedure. Results: Angiography revealed no difference in patency at 72 hours. The stent grafts demonstrated significantly improved blood flow compared to shunts both immediately after intervention and at 72 hours. The pressure gradient across the shunts was greater than that of the stent grafts. Conclusion: Open sutureless direct site repair using stent grafts to treat vascular injury is a feasible strategy for damage control management of peripheral vascular injury and offers increased blood flow when compared to temporary shunts. Furthermore, stent grafts may offer improved durability to extend the window until definitive vascular repair.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 24, 2017
- Accession Number
- AD1027317
Entities
People
- Davidson Anders
Organizations
- David Grant USAF Medical Center