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Peer-reviewedCC BY-NC-NDJournal of vascular surgery cases and innovative techniques

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

  • Zain Moin1
  • Alayne Morrel1
  • Maham Rahimi2
  1. 1Texas A&M School of Engineering Medicine, Houston, TX.
  2. 2Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX.
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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%; P < .001), representing near-elimination of shear-mediated disruption. The procedure time was moderately longer (+32 seconds; P < .05). EndoEx demonstrated superior usability across all domains, including ease of use, safety perception, and overall cognitive load (P < .05).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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Cite

BibTeXRIS
BibTeX
@article{moin2026mechanismguided,
  title = {{Mechanism-guided endograft explantation eliminates shear-mediated aortic injury in a controlled simulation study.}},
  author = {Zain Moin and Alayne Morrel and Maham Rahimi},
  journal = {Journal of vascular surgery cases and innovative techniques},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jvscit.2026.102489},
  url = {https://europepmc.org/article/MED/42904182},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Mechanism-guided endograft explantation eliminates shear-mediated aortic injury in a controlled simulation study.
AU  - Zain Moin
AU  - Alayne Morrel
AU  - Maham Rahimi
PY  - 2026
DA  - 2026/09/03
JO  - Journal of vascular surgery cases and innovative techniques
DO  - 10.1016/j.jvscit.2026.102489
UR  - https://europepmc.org/article/MED/42904182
AB  - 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%; P < .001), representing near-elimination of shear-mediated disruption. The procedure time was moderately longer (+32 seconds; P < .05). EndoEx demonstrated superior usability across all domains, including ease of use, safety perception, and overall cognitive load (P < .05).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.
SN  - 2468-4287
ER  -