First-Generation Aortic Endografts: Analysis of Explanted Stentor Devices from the EUROSTAR Registry
First-Generation Aortic Endografts: Analysis of Explanted Stentor Devices from the EUROSTAR Registry
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第一代主动脉内移植物：来自 EUROSTAR 注册的外植 Stentor 装置的分析
DOI：
10.1177/152660280000700205
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
P. Harris
中科院分区：
文献类型：
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作者：
R. Guidoin;Y. Marois;Y. Douville;M. King;M. Castonguay;A. Traoré;M. Formichi;L. E. Staxrud;L. Norgren;P. Bergeron;J. Becquemin;J. M. Egaña;P. Harris
目的：检查因移行、内漏、血栓形成或动脉瘤扩张而移植的长期植入的支架的结构和愈合特点。方法：再次手术后取材(n=5)，尸检取材(n=1)，植入时间13~53个月。使用放射摄影术、内窥镜和磁共振成像(MRI)检查金属部件的结构修改。取自模块化支架移植物组件的标本进行组织学检查和扫描电子显微镜(SEM)检查，以评估愈合行为。采用扫描电子显微镜和电子能谱等化学分析手段，对镍钛线材和机织聚酯接枝材料的物理和化学稳定性进行了评价。结果：尽管内移植物是由于各种原因被取回的，但它们表现出相似的愈合和结构修改。机织涤纶袖子显示出纱线移动和变形、纱线损坏和长丝断裂的证据，导致织物上形成开口。管腔表面内移植物显示不完全愈合，其特征是组织不良，无粘连的血栓基质厚度不一。放射学和内窥镜观察表明，移植物的结构失效，特别是在主主动脉组件中，与缝线断裂导致金属框架严重压实和脱位有关。在所有器件的一些镍镍线上都观察到了腐蚀痕迹。化学分析和离子轰击表明，钛和镍的表面浓度并不均匀。第一层由碳或有机元素组成，其次是镍浓度较低的高度氧化的钛层；钛镍合金位于这些层的下面。结论：尽管用于构建血管内移植物的材料似乎是明智的，但这些生物材料在装置内组装成各种相互关联的结构需要进一步改进。
Purpose: To examine the structure and healing characteristics of chronically implanted Stentor endografts that were explanted due to migration, endoleak, thrombosis, or aneurysm expansion. Methods: The devices were harvested following reoperation (n = 5) or autopsy (n = 1) with implantation times ranging from 13 to 53 months. Structural modifications to the metal components were examined using radiography, endoscopy, and magnetic resonance imaging (MRI). Specimens taken from components of the modular stent-grafts were examined histologically and with scanning electron microscopy (SEM) to assess healing behavior. Physical and chemical stability of the nitinol wires and woven polyester graft material was evaluated using SEM and electron spectroscopy for chemical analysis. Results: Although the endografts were retrieved for a variety of reasons, they exhibited similar healing and structural modifications. The woven polyester sleeve showed evidence of yarn shifting and distortion, yarn damage, and filament breakage leading to the formation of openings in the fabric. The luminal surface endografts showed incomplete healing characterized by a poorly organized, nonadherent thrombotic matrix of variable thickness. Radiographic and endoscopic observations indicated that structural failure of the grafts, particularly in the main aortic component, was related to severe compaction and dislocation of the metallic frame due to suture breaks. Corrosion marks were observed on some nitinol wires in all devices. Chemical analysis and ion bombardment of the nitinol wires revealed that the surface concentrations of titanium and nickel were not homogenous. The first layer was composed of carbon or organic elements, followed by a stratum of highly oxidized titanium with a low nickel concentration; the titanium-nickel alloy lay beneath these layers. Conclusions: Although the materials selected for construction of endovascular grafts appears judicious, the assembly of these biomaterials into various interrelated structures within the device requires further improvement.