Transcatheter Placement of Intraluminal Prosthesis for Thoracic Aorta

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We have developed new aortic prosthesis and its placement system for the purpose of treating aortic anuerysm with minimal invasion. The new prosthesis which we call SAP (Shape memory Aortic Prosthesis) consists of Nitinol stent and polyurethane tube, and is designed in such a configuration that it could be compressed inside a 14Fr catheter in 0 - 5 ﾟC and regain its original shape above 30ﾟC. Intra-aortic sutureless placement of SAP was performed for 10 mongrel dogs. After 1 to 3 months, aortography was done and they were sacrified to examine pahtological changes of their aorta and SAP. There were neither anuerysmal changes nor wall thinning in the host aorta. Microscopic examinations revealed intimal dip where the stents of SAP had compressed, but elastic layer was preserved well.Placement system is composed of delivery catheter, pushing rod, catching catheter and pulling wire. Using this system, transfemoral placement of SAP was successfully demonstrated within 3 dogs and 1 sheep. Moreover we also succeeded in transfemorally closing the entry of Stanford type B aortic dissections created in animal models. It might be possible that the use of SAP could prevent the progression of dissection and aneurysmal changes. The concept of transformoral grafting of aortic prosthesis is attractive. The second generation of SAP with highly biocompatible materials should be developed.