SCOTTSDALE, ARIZ. — Vascular interventionalists may soon routinely implant pressure sensors that can detect endoleaks during both thoracic and abdominal aneurysm repair.
“Remote pressure sensing for endovascular repair is feasible,” Dr. Ross Milner said at an international symposium on endovascular interventions sponsored by the Arizona Heart Foundation. The sensors have no battery. They are activated by energy waves generated by external probes, which also read the measurement.
In a recent publication, Dr. Milner, of the division of vascular surgery at Emory University, Atlanta, said there are two devices in development, one that uses ultrasound waves and the other, radio waves. Both devices—the ImPressure ultrasound device, Remon Medical Technologies Inc., and the Endosensor, CardioMEMS Inc.—have been implanted in human trials.
The Endosensor device was approved for U.S. marketing in November, based on a 12-center trial. In a report on the trial at the most recent Society for Vascular Surgery meeting, the investigators said the device was implanted in 70 patients undergoing endovascular repair of abdominal aortic aneurysms without complication. It accurately measured pressure in 65 of the patients and detected all 15 endoleaks that occurred during the procedure.
Dr. Milner and his colleagues at Emory have begun using the ImPressure device in thoracic aneurysm repairs, with the first implant done in Brazil last July. That device continued to function well 8 months after implantation, and it has shown a dramatic, continued drop in pulse pressure within the aneurysm sac.
He predicted that, in time, use of these pressure devices may omit the need for CT angiography at the end of procedures to be sure the graft has completely sealed off the aneurysm, thus sparing patients some exposure to contrast agent. “Pressure sensing will be feasible in the thoracic aorta and may add a lot to the follow-up of these patients as it allows for appropriate intraoperative exclusion as well as long-term follow-up,” he said. The sensors are compatible with any graft system, he added.