Abstract:
BACKGROUND:Treatment of aortocaval fistulae (ACFs) by open surgery is known to be a high-risk procedure. In this experimental study, we developed a percutaneous model of ACF to test a new nonsurgical method of treatment of ACF using endovascular stent grafts. METHODS AND RESULTS:An ACF was created percutaneously in eight sheep. Via a combined venous and arterial femoral approach, angioplasty balloons were inserted to occlude the infrarenal aorta and inferior vena cava (IVC). The IVC was punctured through the lateral aortic wall with a transjugular liver biopsy needle. The fistulous tract was then dilated with an 8-mm angioplasty balloon, and the animal was heparinized. Two weeks later, a 10-mm Cragg-Endopro-Stent was inserted into the aorta at the level of the fistula via a percutaneous femoral approach. ACFs were successfully created in all animals, with rapid dye shunt through the fistula and a 20% increase in cardiac pulsations. Follow-up angiograms at 2 weeks showed a patent ACF, and stent implantation excluded the fistula in every case. Angiographic and pathological examinations up to 6 months demonstrated normal aortic patency and persistent exclusion of the fistulae. CONCLUSIONS:ACFs were effectively treated by endovascular grafting of the aorta. The animal model and the stenting procedures were both performed percutaneously.
journal_name
Circulationjournal_title
Circulationauthors
Boudghène F,Sapoval M,Bonneau M,Bigot JMdoi
10.1161/01.cir.94.1.108subject
Has Abstractpub_date
1996-07-01 00:00:00pages
108-12issue
1eissn
0009-7322issn
1524-4539journal_volume
94pub_type
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