Abstract
Compliance mismatch between stent graft and host artery may induce complications and blood flow disorders. However, few studies have been reported on stent graft compliance. This study aims to explore the deformation and compliance of stent graft in stented and unstented zones under three pressure ranges. Compliance of two stent grafts incorporated with polyurethane graft (nitinol-PU) and polyester graft (nitinol-PET) materials respectively were tested; the stents used in the two stent grafts were identical. For the circumferential deformation of the stent grafts under each pressure range, the nitinol-PET stent graft was uniform in both zones. The nitinol-PU stent graft was circumferentially uniform in the stented zone, however, it was nonuniform in the unstented zone. The compliance of the PU graft material was 15 times higher than that of the PET graft. No significant difference in compliance was observed between stented and unstented zones of the nitinol-PET stent graft regardless of the applied pressure range. However, for the nitinol-PU stent graft, compliance of the unstented PU region was approximately twice that of the stented region; thus, compliance along the length of the nitinol-PU stent graft was not constant and different from that of the nitinol-PET stent graft.
Highlights
The use of endovascular stent grafts for endovascular aneurysm repair (EVAR) has been accepted widely since the first application of an endovascular repair technique to treat an abdominal aortic aneurysm (AAA) reported in 1991 by Parodi [1,2]
This paper aims to explore the variation in compliance of an endovascular stent graft, when the stent graft has been assembled with two distinct regions: a stented zone and an unstented zone
There is a big difference between stented zone S3 and unstented zone G3 in our research; this could lead to new blood flow disturbances
Summary
The use of endovascular stent grafts for endovascular aneurysm repair (EVAR) has been accepted widely since the first application of an endovascular repair technique to treat an abdominal aortic aneurysm (AAA) reported in 1991 by Parodi [1,2]. Stent-graft migration, endoleaks [3,4,5,6,7], and fatigue phenomenon [8,9,10,11,12] such as fraying of the yarns and holes in the fabric tubes may occur after surgery, resulting in a high risk of aneurysm rupture [6,13]; secondary interventions are required in approximately 15% to 20% of patients [14]. Compliance mismatch with the host artery can cause biomechanical issues that may trigger local hemodynamic variations including a change in the flow pattern, relative pulsatility, and pulsatile diameter after device implantation [17,18,19,20,21], which could potentially lead to stroke, coronary artery disease, and myocardial infarction [16]. Some studies have been conducted to investigate the blood flow features in vitro or angiography, hemodynamic, scanning-electron-microscopic, and histological analyses in vivo with compliance
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