Active aortic aneurysm sac treatment with shape memory polymer during endovascular aneurysm repair

Andrew Holden; Andrew A Hill; Manar Khashram; Jan M M Heyligers; Arno M Wiersema; Paul D Hayes; Michel M P J Reijnen

doi:10.1016/j.jvscit.2023.101241

Active aortic aneurysm sac treatment with shape memory polymer during endovascular aneurysm repair

J Vasc Surg Cases Innov Tech. 2023 Jun 12;9(3):101241. doi: 10.1016/j.jvscit.2023.101241. eCollection 2023 Sep.

Authors

Andrew Holden¹, Andrew A Hill², Manar Khashram³, Jan M M Heyligers⁴, Arno M Wiersema⁵, Paul D Hayes⁶, Michel M P J Reijnen^{7

8}

Affiliations

¹ Department of Radiology, Auckland City Hospital, Auckland, New Zealand.
² Vascular Services, Auckland City Hospital, Auckland, New Zealand.
³ Department of Vascular and Endovascular Surgery, Waikato Hospital Hamilton, Hamilton, New Zealand.
⁴ Department of Surgery, Elisabeth-TweeSteden Ziekenhuis, Tilburg, The Netherlands.
⁵ Department of Surgery, Dijklander Ziekenhuis, Hoorn, The Netherlands.
⁶ St. John's Innovation Centre, Cambridge, United Kingdom.
⁷ Department of Surgery, Rijnstate, Arnhem, The Netherlands.
⁸ Multi-Modality Medical Imaging Group, University of Twente, Enschede, The Netherlands.

Abstract

Preprocedural image analysis and intraprocedural techniques to fully treat infrarenal abdominal aortic aneurysm sacs outside of the endograft with shape memory polymer (SMP) devices during endovascular aneurysm repair were developed. Prospective, multicenter, single-arm studies were performed. SMP is a porous, self-expanding polyurethane polymer material. Target lumen volumes (aortic flow lumen volume minus endograft volume) were estimated from the preprocedural imaging studies and endograft dimensions. SMP was delivered immediately after endograft deployment via a 6F sheath jailed in a bowed position in the sac. Technical success was achieved in all cases, defined as implanting enough fully expanded SMP volume to treat the actual target lumen volume.

Keywords: Abdominal aortic aneurysm; Aneurysm regression; Aortic endograft; Endovascular aneurysm repair; Shape memory polymer.