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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.i3.10
pages 181-204

Specific Shortcomings of Endograft Design

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
Marc M. Corriveau
Division of Vascular Surgery, McGill University, Montreal
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
Yahye Merhi
Laboratory of Thrombosis and Haemostasis Research Centre, Montreal Heart Institute, Montreal, QC, Canada
Robert McGregor
Imaging Department, Boundary Trails Health Centre Winkler, Manitoba, 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
Yvan Douville
Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec
Stephane Turgeon
Departments of Surgery and Radiology, Laval University and Quebec Biomaterials Institute, CHUQ, Quebec
Martin King
College of Textiles, North Carolina State University, Raleigh, NC
Oren K. Steinmetz
Division of Vascular Surgery, McGill University, Montreal

ABSTRACT

Further to the rapid enlargement of an aneurysm to 5.6 cm in diameter after 3 years of surveillance, a 79-year-old patient was fitted with a Vanguard modular stent graft and monitored on a regular basis for 6 years. Two years later, the aneurysmal sac ruptured. The patient died 1 month after an open surgery. The device was devoid of any encapsulation and the ipsilateral limb was detached from the body. The Nitinol skeleton was mostly maintained, however, some polypropylene sutures were broken. The resulting motion of the sharp-angled Nitinol wires caused abrasion and resulted in a few localized holes that were sufficient to permit blood to percolate through the textile wall. Some polyester yarns in the warp direction were ruptured. The Nitinol wire used in this device was shown to be corrosion resistant but the selection of the polypropylene suture was inappropriate. Because this technology is maturing rapidly, these weaknesses can be avoided in the future generations of endovascular devices. It is recommended that these Nitinol wires be sutured to the fabric and that polyester yarns stronger than 68 decitex in tubes 8 mm in diameter are selected.