A Pilot Study of Open Venous Revascularization using Expandable PTFE Stent Grafts in a Porcine (Sus scrofa) Model

Abstract

Objectives: Traditional repair of traumatic venous injury typically involves open surgical repair via primary suture repair or ligation. Recent evidence from Iraq and Afghanistan has shown improved limb salvage with venous repair. However, complex venous repairs are technically challenging and time-consuming. These traits are not desirable or sometimes possible during damage control surgery or in austere environments. Emerging alternatives are expandable stent-grafts that are designed to expand within a vessel to cover an injury or open a blockage. Methods: 3 Yorkshire cross swine were anesthetized and underwent exposure of the infrarenal inferior vena cava. A 2cm near-circumferential defect was created in the vessel. A 13mm x 5cm expandable PTFE stent graft was deployed into the vessel in an open direct fashion. The swine were awoken and allowed to ambulate. At 72 hours, conduit patency was evaluated by venography. Results: All animals appeared grossly normal with no changes on physical exam to suggest venous insufficiency. At 72 hours, all stents were patent on venography. Conclusion: Direct site endovascular repair of venous injuries utilizing expandable PTFE stent grafts is a feasible technique. This technique is rapid and durable in the short term and may serve as an alternative to venous ligation during damage control surgery.

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Document Details

Document Type
Technical Report
Publication Date
May 23, 2017
Accession Number
AD1035361

Entities

People

  • Anders J. Davidson

Organizations

  • David Grant USAF Medical Center

Tags

Communities of Interest

  • Ground and Sea Platforms

DTIC Thesaurus Topics

  • Afghanistan
  • Cardiovascular Diseases
  • Cardiovascular System
  • Environment
  • Ligation
  • Pilot Studies
  • Surgery
  • Vascular Diseases
  • Veins
  • Vena Cava

Fields of Study

  • Medicine

Readers

  • Trauma Surgery or Emergency Medicine.