Pathophysiology of proximal perigraft endoleak following endovascular repair of abdominal aortic aneurysms: a study using a flow model.

Abstract

to design a flow model to determine whether and why increased proximal neck angulation correlates with increased risk of proximal perigraft endoleak (PPE) flow. a tapered stent-graft (Gianturco stent + Dacron) was deployed with proximal and distal necks made of silicone. The amount of PPE was measured over 30-s periods while the angulation of the proximal neck was increased. PPE flow increased significantly for angulations > or =30 degrees. The graft was lifted off the neck wall and gaps between the stent-graft and the neck created. greater neck angulation increased PPE flow. The stent-graft was lifted off the neck and subsequent gaps created. This model could be used to compare available stent-grafts and to test new designs that would improve the seal in angulated necks.