PDF(Pubmed)
Abstract：
UNASSIGNED: The treatment of infectious aortic disease is still challenging with open surgical debridement and reconstruction using biological, preferably autologous material, being the treatment of choice. However, these procedures are associated with high morbidity and mortality. Endovascular therapy is often considered a bridging method only, since the biologically inactive fabric of the covered stent grafts usually cannot be treated sufficiently with anti-infective agents in the event of a (obligate) consecutive secondary graft infection. This study aims to prove the feasibility of a physician-made pericardium stent graft ex-vivo.
UNASSIGNED: A state-of-the-art TEVAR was modified by separating the fabric from the z-stents and suturing a hand-sewn bovine pericardium tube to the bare metal. Feasibility of preparation, re-sheathing, and delivery is demonstrated in an ex-vivo model.
UNASSIGNED: This first xenogeneic stent graft could be manufactured and deployed successfully. In the future this may provide a bridging alternative for high-risk patients with infected native aortic aneurysm or aortic fistulas, eventually followed by surgical or thoracoscopic/laparoscopic debridement. Further studies on simulators or animal models are needed to test the technique and investigate its long-term durability. Additionally, this study prompts reflection on whether materials currently used should be further developed to prevent graft infections.
UNASSIGNED: A state-of-the-art TEVAR was modified by separating the fabric from the z-stents and suturing a hand-sewn bovine pericardium tube to the bare metal. Feasibility of preparation, re-sheathing, and delivery is demonstrated in an ex-vivo model.
UNASSIGNED: This first xenogeneic stent graft could be manufactured and deployed successfully. In the future this may provide a bridging alternative for high-risk patients with infected native aortic aneurysm or aortic fistulas, eventually followed by surgical or thoracoscopic/laparoscopic debridement. Further studies on simulators or animal models are needed to test the technique and investigate its long-term durability. Additionally, this study prompts reflection on whether materials currently used should be further developed to prevent graft infections.
摘要：
■使用生物技术进行开放性手术清创和重建，对感染性主动脉疾病的治疗仍然具有挑战性。最好是自体材料，作为治疗的选择。然而,这些手术与高发病率和高死亡率相关.血管内治疗通常被认为只是一种桥接方法，因为在(专性)连续继发性移植物感染的情况下,覆膜支架移植物的无生物活性织物通常不能用抗感染剂充分治疗。本研究旨在证明医生体外制造的心包支架移植物的可行性。
■通过将织物与z-支架分离并将手工缝制的牛心包管缝合到裸金属上来修改最先进的TEVAR。准备的可行性,重新护套，和递送在离体模型中证明。
■可以成功制造并部署第一个异种支架移植物。将来，这可能为感染天然主动脉瘤或主动脉瘘的高危患者提供桥接替代方案。最终进行手术或胸腔镜/腹腔镜清创。需要对模拟器或动物模型进行进一步研究，以测试该技术并研究其长期耐久性。此外,这项研究促使人们反思是否应进一步开发目前使用的材料以防止移植物感染。
■通过将织物与z-支架分离并将手工缝制的牛心包管缝合到裸金属上来修改最先进的TEVAR。准备的可行性,重新护套，和递送在离体模型中证明。
■可以成功制造并部署第一个异种支架移植物。将来，这可能为感染天然主动脉瘤或主动脉瘘的高危患者提供桥接替代方案。最终进行手术或胸腔镜/腹腔镜清创。需要对模拟器或动物模型进行进一步研究，以测试该技术并研究其长期耐久性。此外,这项研究促使人们反思是否应进一步开发目前使用的材料以防止移植物感染。
