Work

EndoEx: Benchtop and cadaveric evaluation of a novel endograft removal device

Year: 2025

Type: article

Abstract: Endovascular abdominal aortic aneurysm repair (EVAR) has improved short term patient outcomes as compared to open techniques. However, endograft complications, particularly infection and endoleaks, may necessitate removal of the graft and fixation spines. Current explanation techniques are limited, often relying on repurposed tools like modified syringes, which can damage the aortic wall or nearby vessels during removal and lead to serious complications such as aortic dissection, renal injury, and catastrophic bleeding, with mortality rates up to 30%. In response, the EndoEx device was developed, designed specifically for safe and controlled graft removal, especially regarding the suprarenal fixation spines. The device uses specific geometry and features designed to limit mechanical damage associated with vessel trauma and improve ease of use. This study compared EndoEx to the current standard of care, a modified syringe, through benchtop hydrogel testing, ex vivo bovine aorta models, and cadaveric explantation of suprarenal Cook stent grafts. EndoEx showed reduced damage surface area in benchtop hydrogel testing as compared to the modified syringe (0±0 cm 2 vs 3.97±0.2 cm 2 ), elimination of the snow-plowing effect during animal tissue testing and reduced gross damage during cadaveric explantation. This study demonstrates that the EndoEx device significantly reduces mechanical damage during experimental, animal tissue, and preliminary human cadaveric models. This reduction in damage may confer a reduction in aortic wall injury during graft explantation, potentially leading to a safer and more effective solution that may substantially decrease morbidity and mortality in complex EVAR explant procedures.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2025.101962

Authors: Brandon Look Fong, Rishik Puppala, Zain Moin, Alayne Morrel, Maham Rahimi

Institutions: Texas A&M University, Houston Methodist

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250