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

Circulation
F BoudghèneJ M Bigot

Abstract

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. 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. ACFs were effectively treated by endovascular grafting of the aorta. The animal model...Continue Reading

References

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Citations

Jun 17, 1998·Cardiovascular and Interventional Radiology·C J BeveridgeJ D Rose
Feb 13, 2001·ANZ Journal of Surgery·C Duong, N Atkinson
Jun 13, 2006·The Journal of Trauma·Rina Maria Pereira PortaDario Birolini
Feb 3, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·François GodartMohamad Koussa
Sep 13, 2001·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·P SoulaH Rousseau
Jul 5, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Abul Hasan Muhammad BasharSatoshi Baba
Dec 5, 2006·Journal of Vascular and Interventional Radiology : JVIR·Dimitris KarnabatidisDimitris Siablis
Sep 8, 2007·Annals of Vascular Surgery·E LaxdalS Aune
Oct 18, 2012·ANZ Journal of Surgery·Robert E BrightwellNicholas Boyne

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