Purpose.The treatment of infectious aortic disease is still challenging with open surgical debridement and reconstruction using biological, preferably autologous material, being the treatment of choice. However, these procedures are associated with high morbidity and mortality. Endovascular therapy is often considered a bridging method only, since the biologically inactive fabric of the covered stent grafts usually cannot be treated sufficiently with anti-infective agents in the event of a (obligate) consecutive secondary graft infection. This study aims to prove the feasibility of a physician-made pericardium stent graft ex-vivo.Technique.A state-of-the-art TEVAR was modified by separating the fabric from the z-stents and suturing a hand-sewn bovine pericardium tube to the bare metal. Feasibility of preparation, re-sheathing, and delivery is demonstrated in an ex-vivo model.Conclusion.This first xenogeneic stent graft could be manufactured and deployed successfully. In the future this may provide a bridging alternative for high-risk patients with infected native aortic aneurysm or aortic fistulas, eventually followed by surgical or thoracoscopic/laparoscopic debridement. Further studies on simulators or animal models are needed to test the technique and investigate its long-term durability. Additionally, this study prompts reflection on whether materials currently used should be further developed to prevent graft infections.

中文翻译：

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医生制造的心包支架移植物作为感染性主动脉疾病的潜在血管内替代品——一项离体概念验证研究

目的：感染性主动脉疾病的治疗仍然具有挑战性，开放式手术清创和使用生物材料（最好是自体材料）进行重建是首选治疗方法。然而，这些手术的发病率和死亡率较高。血管内治疗通常被认为只是一种桥接方法，因为在（必然的）连续继发性移植物感染的情况下，覆盖支架移植物的生物非活性织物通常不能用抗感染药物充分治疗。本研究旨在证明医生离体制作心包支架移植物的可行性。技术。通过将织物与 z 形支架分离并缝合手工缝制的牛心包管，对最先进的 TEVAR 进行修改到裸机。在离体模型中证明了准备、重新鞘管和输送的可行性。结论。第一个异种覆膜支架可以成功制造和部署。将来，这可能为患有感染性主动脉瘤或主动脉瘘的高危患者提供一种桥接替代方案，最终进行手术或胸腔镜/腹腔镜清创术。需要对模拟器或动物模型进行进一步的研究来测试该技术并研究其长期耐久性。此外，这项研究促使人们思考是否应该进一步开发目前使用的材料来预防移植物感染。