Aortocaval fistulae: a percutaneous model and treatment with stent grafts in sheep.

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

Circulation

journal_title

Circulation

authors

Boudghène F,Sapoval M,Bonneau M,Bigot JM

doi

10.1161/01.cir.94.1.108

subject

Has Abstract

pub_date

1996-07-01 00:00:00

pages

108-12

issue

1

eissn

0009-7322

issn

1524-4539

journal_volume

94

pub_type

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