Stent fabric fatigue of grafts supported by Z-stents versus ringed stents: An in vitro buckling test

Jing, Lin; Wang, Lu; Guidoin, Robert; Nutley, Mark; Song, Gyun Jee; Zhang, Ze; Du, Jinglei; Douville, Yvan

doi:10.1177/0885328213488228

Cited by 16 publications

(19 citation statements)

References 72 publications

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“…The importance of this undertaking is illustrated by the plethora of patents granted during the last decade . The durability of the fenestration raises some questions despite highly rewarding clinical results because the pressure of the pulsatile blood flow might further enlarge the fenestration resulting in ostial leak . Any woven fabric has a tendency to fray further to the fenestration, depending on the fabric structure and count.…”

Section: Discussionmentioning

confidence: 99%

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In Vitro Laser Fenestration of Aortic Stent‐Grafts: A Qualitative Analysis Under Scanning Electron Microscope

et al. 2016

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In situ fenestration of stent-grafts allows patients with life threatening aortic pathologies to be amenable to emergent "off the shelf indications for use" percutaneous treatments as a bail out technique. Three types of aortic stent-grafts were subjected to laser fenestration in a physiological saline solution followed by balloon angioplasty using 8, 10 or 12 mm in diameter noncompliant balloons. The morphology and the size of fenestrations were observed under optical and scanning electron microscopy. The damage to the fabrics was analyzed and quantified. The creation of fenestrations was feasible in all devices, with varying degrees of fraying and/or tearing. The monofilament twill weave (Medtronic Valiant) tore in two directions (warp and weft) while the multifilament weave fenestrations showed more fraying (Anaconda Vascutek and Zenith TX2 Cook). The size and directions of tearing were more predictable with the 8 mm diameter balloon whereas the results obtained with the 10 and 12 mm diameter balloons were more unpredictable. The fenestrations were free of melting of the yarns and blackening of the filaments. The in situ fenestration is feasible but the observed damage to the fabric constructions must be carefully considered. This procedure must currently be limited to urgent and emergent life threatening cases because it is off indications for use for approved devices.

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Section: Discussionmentioning

confidence: 99%

“…When the yarns are preserved as in this experiment, fraying of fabric can further extend. This is why we proposed the addition of a cuff to better control the ostia area . The focus of this study was solely on the fabrics.…”

Section: Study Limitationsmentioning

confidence: 99%

In Vitro Laser Fenestration of Aortic Stent‐Grafts: A Qualitative Analysis Under Scanning Electron Microscope

et al. 2016

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“…Very rapidly, it became evident that Donghua could do much better than providing just a technological service. Joint programs were launched based upon the complementarity of these two institutions (Ji et al, 2010;Lin, Shen, Wang, & Guidoin, 2011;Liu, Wang, Lin, & Guidoin, 2012;Wang et al, 2014). Cardiovascular devices were investigated at both places: In general, biological and surgical aspects were investigated at Laval University, while materials aspects were investigated at Donghua University.…”

Section: Evolution Of the Laval University-donghua University Collabomentioning

confidence: 99%

Towards Mutuality in the Canada-China Relationship: The Experience of the Department of Surgery at Laval University since the 1980s

2015

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The Department of Surgery at Laval University has been a key player in the development of Canada-China cooperation since the 1980s. The projects initiated and developed by Jean Couture and Guojin Liu to address cancer issues, and specifically breast cancer, were heralded as outstanding successes. In the meantime, the Department of Surgery at Laval University trained numerous Chinese scholars, students, and post-doctoral fellows who became leaders in their fields of expertise. A few of these scholars and students settled in Canada, but the vast majority returned home. Since 2007, a highly specialized research program related to surgical implants with the College of Textiles at Donghua University has been opening new avenues in medical textiles to develop expertise through student training, to launch bridges between textile engineers and clinicians, and to provide the industry with a unique expertise. The final goal is to improve the accessibility and affordability of health care delivery in both Canada and China. China is now a key player in related research and no longer requires foreign assistance. Since it can easily find multiple partners, Canada must be alert to building on its legacy and maintaining its privileged position. China is now a place for Canadian champions.

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“…We have previously shown that long-term buckling of the stent-graft can cause fabric damage at the apexes of sharp-angled Z-stents [37]. The design of such stents has been addressed in the most recent generation of stent-grafts [38,39]. …”

Section: Introductionmentioning

confidence: 99%

An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents

Jing

Guidoin

et al. 2016

Materials

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Whereas buckling can cause type III endoleaks, long-term twisting of a stent-graft was investigated here as a mechanism leading to type V endoleak or endotension. Two experimental device designs supported with Z-stents having strut angles of 35° or 45° were compared to a ringed control under accelerated twisting. Damage to each device was assessed and compared after different durations of twisting, with focus on damage that may allow leakage. Stent-grafts with 35° Z-stents had the most severe distortion and damage to the graft fabric. The 45° Z-stents caused less fabric damage. However, consistent stretching was still seen around the holes for sutures, which attach the stents to the graft fabric. Larger holes may become channels for fluid percolation through the wall. The ringed stent-graft had the least damage observed. Stent apexes with sharp angles appear to be responsible for major damage to the fabrics. Device manufacturers should consider stent apex angle when designing stent-grafts, and ensure their devices are resistant to twisting.

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Stent fabric fatigue of grafts supported by Z-stents versus ringed stents: An in vitro buckling test

Cited by 16 publications

References 72 publications

In Vitro Laser Fenestration of Aortic Stent‐Grafts: A Qualitative Analysis Under Scanning Electron Microscope

In Vitro Laser Fenestration of Aortic Stent‐Grafts: A Qualitative Analysis Under Scanning Electron Microscope

Towards Mutuality in the Canada-China Relationship: The Experience of the Department of Surgery at Laval University since the 1980s

An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents

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