Outcomes of original and low-permeability Gore Excluder endoprosthesis for endovascular abdominal aortic aneurysm repair

Bench-top comparison of original permeability and low permeability devices. Prostheses are soaked in alcohol before testing to “wet out” the material, breaking down the expanded polytetrafluoroethylene hydrophobic barrier, and then pressurized with bovine serum. This process produces obvious transmigration of serum in the original endoprosthesis construct, but not in the low permeability endoprosthesis. Material permeability changed from 0.233 gm/(min × cm²) to 0.000 gm/(min × cm²). (Figure and data courtesy W.L. Gore Medical Products Division.)

Abdominal aortic aneurysm (AAA) diameter change relative to the 1-month postoperative computed tomography scan. At 6 months, the change was original permeability (OP), −1.6 ± 0.3 mm, and low permeability (LP), −2.1 ± 0.6 mm (P = .4), and at 12 months the change was OP, −2.1 ± 0.6 mm, and LP −5.1 ± 1 mm (P = .01).

Abdominal aortic aneurysm (AAA) three-dimensional (3D) volume change relative to the 1-month postoperative computed tomography scan. In this case, 3D volume was measured from the most distal renal artery to the most proximal internal iliac artery. At 6 months the change was original permeability (OP), −4.9% ± 1%, and low permeability (LP) −11% ± 2% (P = .01), and at 12 months the change was OP, −6.8% ± 2%, and LP, −19% ± 3% (P = .0006).

Abdominal aortic aneurysm (AAA) size change by time interval for long-term follow-up of the original permeability group. The change in three-dimensional volume is shown for size change relative to the last computed tomography (CT) scan (rather than change relative to the first postoperative scan) to demonstrate changes in sac behavior over each specific time interval. Diameter trends were very similar.