Implanted device may identify leaks following stenting for aneurysm.
If this type of implanted transducer proves to be reliable and effective, it may eliminate the need for serial assessments by computed tomography (CT) in patients who have had endovascular aneurysm repairs, Dr. Robert Lookstein said at the 16th International Symposium on Endovascular Therapy.
The device, which measures 3 by 9 by 1.5 mm, is made as the ImPressure by Remon Medical Technologies Ltd. in Israel. Dr. Lookstein neither received research support from Remon and he has no financial interest in the company.
A transducer was sewn onto the outside of a Talent endovascular stent graft about 6 cm below the proximal attachment site. The grafts were then placed in 14 patients who underwent endovascular repair of an abdominal aortic aneurysm. The mean follow-up was 2.6 months, with one patient followed for 6 months.
The transducer succeeded in sending information acutely for all 14 patients. Pressure within the aneurysm was measured at the time of repair by both the implanted devices and by an intravascular catheter. The correlation coefficient of the transducer to the catheter was 0.97 for both systolic and diastolic pressure in 12 of the 14 patients, reported Dr. Lookstein, an interventional radiologist at Mount Sinai Medical Center, New York. In one patient, the catheter could not be placed to get a comparison measure. In another, the transducer reading was not obtained until after the catheter had been pulled.
Subsequent measurements by the transducer were compared with assessments done by CT, the standard method for monitoring for leaks in endovascular aneurysm repairs, and with conventional blood pressure measurement. Postoperative pressure readings were obtained for all 14 patients, although one device stopped working after 2 months. The readings showed that pressure within the aneurysm fell precipitously within the aneurysm sac after the sac was successfully closed and shrunk. This sharp fall in sac pressure was not seen in three patients who developed endoleaks. Data from additional patients and longer follow-up are needed to further define the clinical significance of pressure measurement made by the implanted transducer, he said.
BY MITCHEL L. ZOLER
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|Title Annotation:||Cardiovascular Medicine|
|Author:||Zoler, Mitchel L.|
|Publication:||Internal Medicine News|
|Date:||Jul 1, 2004|
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