ArticleJournal of vascular surgery cases and innovative techniques2026
Mechanism-guided endograft explantation eliminates shear-mediated aortic injury in a controlled simulation study.
Article in Journal of vascular surgery cases and innovative techniques, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Endograft explantation is associated with high morbidity and mortality, driven in part by uncontrolled shear-mediated aortic injury. In this study, we evaluated whether a mechanism-based explantation device could reduce this injury and improve the procedural performance. Methods: In a controlled simulation using a multilayered three-dimensional printed aortic model, 25 vascular trainees and surgeons performed endograft explantation using both a conventional syringe technique and a novel device (EndoEx). The outcomes included quantitative intimal injury, procedure 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%; Conclusions: In this controlled simulation, a mechanism-based explantation strategy (EndoEx) markedly 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 endovascular aneurysm repair explantation that warrants clinical validation.
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