Histologic Analysis with the Newly Designed Exoskeleton Seal® Stent-Graft in the Porcine Abdominal Aorta

  • Jung-Hoon Park
  • Young Kwon ChoEmail author
  • Keun Her
  • Yong Sun Jeon
  • Jeong Ho Kim
  • Tae-Seok Seo
  • Myung Gyu Song
Laboratory Investigation Arterial Interventions
Part of the following topical collections:
  1. Arterial Interventions



To investigate the technical feasibility of a novel exoskeleton Seal® stent-graft and analyze early histologic changes in the porcine abdominal aorta.

Materials and Methods

Six pigs received an abdominal stent-graft (Group I), and six received an iliac branch stent-graft (Group II). Groups were subdivided as follows: Group Ia, which received three bifurcated main-body stent-grafts; Group Ib, which received three bifurcated main-body stent-grafts with both iliac graft-stents; Group IIa, which received three simple uni-iliac tapered stent-grafts; and Group IIb, which received three uni-iliac tapered tapered stent-grafts with right straight limb and left branched limb. Statistical analyses were performed with the Wilcoxon signed-rank test and mixed-model regression analysis.


The primary technical success rate (< 24 h) was 83% because of two acute thromboses in the lumen of the stented abdominal aorta immediately after stent-graft placement. At 4 weeks, late thrombosis occurred in two pigs. Higher mean neointimal hyperplasia areas (23.5% vs. 16.2%; P = .047), neointimal hyperplasia thicknesses (545.5 μm vs. 422.2 μm; P = .001), and degrees of collagen deposition (2.71 vs. 2.33; P = .002) were observed at the bare-metal stent-graft compared with the proximal exoskeleton portion of the stent-graft, with no significant differences between the patent and occluded groups or among the four types of stent-grafts.


The exoskeleton stent-graft demonstrates 66% of patency rate during 1-month follow-up due to four cases of thromboses; however, the endothelialization on the junction of proximal graft showed no significant differences between the patent and occluded groups. Further studies should investigate long-term outcomes with prolonged neointimal hyperplasia.


Exoskeleton stent-graft Animal studies Porcine abdominal aorta Thrombotic occlusions Neointimal hyperplasia 



The study was supported by a Grant No. 2018-10 from the Kangdong Sacred Heart Hospital Fund.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

Informed Consent

For this type of study informed consent is not required.

Consent for Publication

For this type of study consent for publication is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  1. 1.Biomedical Engineering Research Center and Department of Radiology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of Radiology, Kangdong Seong-Sim HospitalHallym University College of MedicineSeoulKorea
  3. 3.Department of Thoracic Surgery, Soonchunhyang Bucheon University HospitalSoonchunhyang University College of MedicineBucheonKorea
  4. 4.Department of Radiology, Inha University HospitalInha University College of MedicineIncheonKorea
  5. 5.Department of Radiology, Gachon University Gil HospitalGachon University College of MedicineIncheonKorea
  6. 6.Department of Radiology, Korea University Guro HospitalKorea University College of MedicineSeoulKorea

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