Air Embolism During TEVAR: Liquid Perfluorocarbon Absorbs Carbon Dioxide in a Combined Flushing Technique and Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment in an Experimental Setting.

Rohlffs, Fiona; Trepte, Constantin; Ivancev, Krassi; Tsilimparis, Nikolaos; Makaloski, Vladimir; Debus, E Sebastian; Kölbel, Tilo (2019). Air Embolism During TEVAR: Liquid Perfluorocarbon Absorbs Carbon Dioxide in a Combined Flushing Technique and Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment in an Experimental Setting. Journal of endovascular therapy, 26(1), pp. 76-80. Sage 10.1177/1526602818819501

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PURPOSE

To investigate the influence of flushing thoracic stent-grafts with carbon dioxide and perfluorocarbon on the amount of gas released during stent-graft deployment in thoracic endovascular aortic repair (TEVAR).

MATERIALS AND METHODS

Ten TX2 ProForm thoracic stent-grafts were deployed into a water-filled container with a curved plastic pipe and flushed sequentially with carbon dioxide, 20 mL of liquid perfluorocarbon (PFC), and 60 mL of saline. Released gas was measured using a calibrated setup. The volume of released gas was compared with the results of an earlier published reference group, in which identical stent-grafts were flushed with 60 mL saline alone as recommended in the instructions for use.

RESULTS

The average amount of gas released in the test group was 0.076 mL, significantly lower (p<0.001) than the mean 0.79 mL of gas released in the reference group. Big bubbles appearing at the tip of the sheath when deployment was started were seen in all grafts of the reference group but in only 2 of the test group stent-grafts. Small bubbles were less frequent in the test group.

CONCLUSION

The amount of gas released from thoracic stent-grafts during deployment can be influenced by different flushing techniques. The use of PFC in addition to the carbon dioxide flushing technique reduces the volume of gas released during deployment of tubular thoracic stent-grafts to a few microliters. This significant effect is presumably based on the high solubility of carbon dioxide in perfluorocarbon and could be a potential future approach to lower the risk of cerebral injury and stroke from air embolism during TEVAR.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery
UniBE Contributor:	Makaloski, Vladimir
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1526-6028
Publisher:	Sage
Language:	English
Submitter:	Daniela Huber
Date Deposited:	09 Jan 2019 10:06
Last Modified:	27 Feb 2024 14:28
Publisher DOI:	10.1177/1526602818819501
PubMed ID:	30569808
Uncontrolled Keywords:	air embolism aorta aortic aneurysm carbon dioxide endograft flushing technique perfluorocarbon stent-graft stroke thoracic aorta thoracic endovascular aortic repair
URI:	https://boris.unibe.ch/id/eprint/123098