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Journal of Long-Term Effects of Medical Implants

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.v18.i3.20
pages 205-225

Persistent Type II Endoleak Unrelated to an Anaconda Aortic Stent Graft Fulfilling the 3Bs Requirements of Biofunctionality, Biodurability, and Biocompatibility

Tieying Yin
Dept. of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Canada; Key Laboratory of Biorheological Science and Technology, Bioengineering College, Chongqing University, Chongqing, PR China
Robert Guidoin
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Axe Medecine Regeneratrice, Centre de Recherche du CHU, Quebec, QC, Canada
Mark Nutley
Division of Vascular Surgery and Department of Diagnostic Imaging, University of Calgary, Peter Lougheed Health Centre (AB), Calgary, Canada
Lu Xu
Key Laboratory of Textile Science and Technology of Ministry of Education, Donghua University, Shanghai
Georgi R. Marinov
Department of Anatomy, Histology and Embryology, Medical University of Varna, Varna
Lu Wang
Key Laboratory of Textile Science and Technology of the Ministry of Education, College of Textile, Donghua University, Shanghai, China
Robert McGregor
Imaging Department, Boundary Trails Health Centre Winkler, Manitoba, Canada
Xingyi Xie
Departments of Surgery and Radiology, Laval University and Québec Biomaterials Institute CHUQ, Quebec; Department of Polymeric Biomaterials and Artificial Organs, College of Polymer Science and Engineering, Sichuan University, Chengdu, PR China
Yahye Merhi
Laboratory of Thrombosis and Haemostasis Research Centre, Montreal Heart Institute, Montreal, QC, Canada
Ze Zhang
Department of Surgery, Faculty of Medicine, Laval University, Quebec, QC, Canada; Axe Medecine Regeneratrice, Centre de Recherche du CHU, Quebec, QC, Canada
Stephane Turgeon
Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec
Guixue Wang
Bioengineering College, Chongqing University, Chongqing
Martin King
College of Textiles, North Carolina State University, Raleigh, NC
Mahmoud Rouabhia
GREB, Faculty of Dentistry, Laval University, Québec
Randolph Guzman
Vascular Surgery, St. Boniface General Hospital and Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
Guy Dionne
Departments of Surgery and Radiology, Faculty of Medicine, Laval University, Axe Medecine Regeneratrice, Centre de Recherche, CHU, Quebec, (QC) Canada
Yvan Douville
Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec

ABSTRACT

A patient was fitted with an Anaconda stent graft for which there was a persistent type II endoleak. Two subsequent attempts at embolization were unable to resolve the endoleak. The diameter of the aneurysm varied initially from 5.5 cm in diameter down to 4.8 cm but then later re-dilated to 6.1 cm, with evidence of persistent flow into the aneurysmal sac from the inferior mesenteric artery. Results from serial computed tomography scans demonstrated clear evidence of a type II endoleak that originated from the inferior mesenteric artery with outflow to a distal lumbar artery. The harvested stent graft did not show evidence of a device-related failure. The stent graft and its modular segments were found to have been properly deployed. Only a thin external capsule was evident at explantation. The internal wall of the device showed irregular and thin encapsulation with scattered mural thrombi, which were more prominent at the bifurcation of the main body of the device. Blood deposits and tissue development were sufficient to prevent blood oozing through the wall. The explanted Anaconda stent graft was devoid of any construction flaws or damage (fatigue of the textile or corrosion of the Nitinol wires) after implantation.