2004 Fiscal Year Final Research Report Summary
Development of entry closure device that can be percutaneously inserted
| Project/Area Number |
13670929
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Radiation science
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| Research Institution | Mie University |
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Principal Investigator |
KATO Noriyuki Mie University, Faculty of Medicine, Associate Professor, 医学部, 助教授 (40214390)
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| Co-Investigator(Kenkyū-buntansha) |
SHIMONO Takatugu Mie University, Faculty of Medicine, Associate Professor, 医学部, 助教授 (80206242)
TAKEDA Kan Mie University, Faculty of Medicine, Professor, 医学部, 教授 (70106988)
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| Project Period (FY) |
2001 – 2004
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| Keywords | aortic dissection / endovascular treatment / stent-graft |
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| Research Abstract |
We have already shown the efficacy of entry closure with stent-grafts for the treatment of aortic dissection by both animal experiment and clinical practice. However, the delivery of currently available stent-grafts still requires at least an 18Fr sheath and arteriotomy is mandatory in all cases. In addition, the procedure must sometimes be abandoned due to the true lumen markedly compressed and narrowed by the false lumen ; The purpose of this research is to develop a new device that is thin enough as to be inserted percutaneously and to spread the indication of endovascular repair with stent-grafts.
We developed two kinds of stent-grafts. One is a patched-stent ; i.e. a Gianturco Z-stent that is partially covered by expanded porytetrafluoroethylene(ePTFE). The other is a modular stent composed of two stent bodies that are connected by long struts. Only middle portion of the stent was covered with ePTFE. After its deployment bare stent is supposed to be deployed inside it to fully support the graft. Finally, both devices could be inserted into a 10Fr sheath after trying various kinds of stainless steel wire and graft materials.
In animal experiment modular stents could completely occlude the intercostal arteries in two dogs. In contrast occlusion of a renal artery was not obtained with a patched-stent in one dog. Although addition of another stent could occlude the renal artery, it occluded the other renal artery together. In another dog a patched-stent could not occlude intercostal arteries, either. Even after additional stenting occlusion of the arteries were not obtained.
In the near future we are going to add modifications to a patched-stent, i.e. attachment of a marker indicating the graft-covered surface of the stent and adding a bare stent after placing the patched stent. With both modular stents and modified patched stents we are going to close entry tears in dissection models created in mongrel dogs.
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