%0 Journal Article
%T Distribution of Air Embolization During TEVAR Depends on Landing Zone: Insights From a Pulsatile Flow Model
%A Bent £¿hlenschlaeger
%A Constantin Trepte
%A E. Sebastian Debus
%A Fiona Rohlffs
%A J¨¹rg Schmidli
%A Tilo K£¿lbel
%A Vladimir Makaloski
%J Journal of Endovascular Therapy
%@ 1545-1550
%D 2019
%R 10.1177/1526602819849931
%X Purpose: To analyze the distribution of air bubbles in the supra-aortic vessels during thoracic stent-graft deployment in zones 2 and 3 in an aortic flow model. Materials and Methods: Ten identical, investigational, tubular, thoracic stent-grafts were deployed in a glass aortic flow model with a type I arch: 5 in zone 2 and 5 in zone 3. A pulsatile pump generated a flow of 5 L/min with systolic and diastolic pressures (¡À5%) of 105 and 70 mm Hg, respectively. The flow rates (¡À5%) were 300 mL/min in the subclavian arteries, 220 mL/min in the vertebral arteries, and 400 mL/min in the common carotid arteries (CCAs). The total amounts of air released in each supra-aortic branch and in the aorta were recorded. Results: The mean amounts of air measured were 0.82¡À0.23 mL in the zone-2 group and 0.94¡À0.28 mL in the zone-3 group (p=0.49). In the zone-2 group compared with zone 3, the amounts of released air were greater in the right subclavian artery (0.07¡À0.02 vs 0.02¡À0.02 mL, p<0.01) and right CCA (0.30¡À0.8 vs 0.18¡À07 mL, p=0.04). There were no differences between the groups concerning the mean amounts of air measured in the right vertebral and all left-side supra-aortic branches. The amount of air released in the descending aorta was significantly higher in the zone-3 group vs the zone-2 group (0.48¡À0.12 vs 0.13¡À0.08 mL, p<0.01). Small bubbles were observed continuously during deployment, whereas large bubbles appeared more commonly during deployment of the proximal stent-graft end and after proximal release of the stent-graft. Conclusion: Air is released into all supra-aortic branches and the descending aorta during deployment of tubular thoracic stent-grafts in zones 2 and 3 in an aortic flow model. Higher amounts of air were observed in right-side supra-aortic branches during deployment in zone 2, whereas significantly greater amounts of air were observed in the descending aorta during deployment in zone 3
%K air embolism
%K aortic flow model
%K descending thoracic aorta
%K in vitro model
%K landing zones
%K thoracic aorta
%K thoracic stent-graft
%K supra-aortic branch
%U https://journals.sagepub.com/doi/full/10.1177/1526602819849931