The Role of Endovascular Stents in an Experimental Model of Traumatic Arterial Occlusion – the Temporary Endo-Shunt

Authors

  • Viktor A Reva
  • Marta J Madurska
  • Igor M Samokhvalov
  • Alexey V Denisov
  • Sergey Yu Telickiy
  • Alexey B Seleznev
  • Igor S Zheleznyak
  • Valery N Adamenko
  • Kenji Inaba

DOI:

https://doi.org/10.26676/jevtm.v4i1.116

Keywords:

Vascular Trauma, Occlusion, Covered Stent, Bare Metal Stent, Recanalization, Endovascular Trauma Management

Abstract

Background: The aim of this study was to evaluate patency following the deployment of a bare-metal stent (BMS) or covered stent (CS) across a traumatic occlusive peripheral arterial lesion and to estimate the feasibility of urgent stent placement for temporary endovascular shunting.
Methods: Fifteen sheep (25–45 kg) underwent laparoscopic creation of a left external iliac artery (EIA) thrombosis by means of repeated clamping. Sixty minutes after achievement of thrombotic occlusion, animals were randomized into one of three groups: no-treatment (control group), a BMS group, or CS group. Animals were followed up for 30 days with no anticoagulants or anti-platelet drugs administered postoperatively. Doppler ultrasound, computed tomography angiography (CTA), and digital subtraction angiography (DSA) were used to evaluate EIA patency.
Results: Stent implantation resulted in the restoration of in-line flow through the EIA in all cases. The peak systolic velocity (PSV) in the injured limb increased from 10 (0–16) to 31 (28–37) cm/s in the BMS group (p < 0.0001) and from 15 (7–18) to 24 (21–29) cm/s in the CS group (p = 0.043) immediately after stent deployment (both p = 0.001 compared with the control group). There was no difference in the PSV between the groups at post-injury day 3, and thereafter. Day-14 CTA and day-30 DSA demonstrated only one patent stent in each study group.
Conclusions: Urgent stent (BMS or CS) implantation can restore arterial patency of a traumatic occlusion for a short period of time and serve as a temporary endovascular shunt. Distal embolization can complicate this procedure and worsen long-term patency.

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Published

2020-05-30

How to Cite

Reva, V. A., Madurska, M. J., Samokhvalov, I. M., Denisov, A. V., Telickiy, S. Y., Seleznev, A. B., … Inaba, K. (2020). The Role of Endovascular Stents in an Experimental Model of Traumatic Arterial Occlusion – the Temporary Endo-Shunt. Journal of Endovascular Resuscitation and Trauma Management, 4(1), 40–48. https://doi.org/10.26676/jevtm.v4i1.116

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Original Article

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