Work

Mechanism-guided endograft explantation eliminates shear-mediated aortic injury in a controlled simulation study

Year: 2026

Type: article

Abstract: Objective Endograft explantation is associated with high morbidity and mortality, driven in part by uncontrolled shear-mediated aortic injury. We evaluated whether a mechanism-based explantation device could reduce this injury and improve procedural performance. Methods In a controlled simulation using a multilayered 3D-printed aortic model, 25 vascular trainees and surgeons performed endograft explantation using both a conventional syringe technique and a novel device (EndoEx). Outcomes included quantitative intimal injury, procedural time, and validated usability metrics. Results The EndoEx device reduced intimal injury by approximately 90% compared with the syringe technique (0.94% vs 9.56%, p<0.001), representing near-elimination of shear-mediated disruption. Procedural time was modestly longer (+32 seconds, p<0.05). EndoEx demonstrated superior usability across all domains, including ease of use, safety perception, and overall cognitive load (p<0.05). Conclusions In this controlled simulation, a mechanism-based explantation strategy (EndoEx) drastically reduced shear-mediated aortic injury while improving operator control. These findings support further in vivo evaluation and establish a mechanistic foundation for a device-based approach to EVAR explantation that warrants clinical validation.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2026.102489

Authors: Zain Moin, Alayne Morrel, Maham Rahimi

Institutions: Texas A&M University, Houston Methodist

Language: English

Topic: Aortic aneurysm repair treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250