`
`Radiology
`
`. Kenneth
`
`David
`C. Wright,
`
`D. Lawrence,
`PhD
`#{149}Cesar
`
`Jr., MD
`Gianturco,
`
`#{149}Chusilp
`MD
`
`Charnsangavej,
`#{149}Sidney
`Wallace,
`
`MD
`MD
`
`Percutaneous
`
`Endovascular
`Experimental
`
`Graft:
`Evaluation(cid:1)
`
`was
`graft
`endovascular
`arterial
`An
`a Dacron
`by wrapping
`constructed
`around
`the Gianturco
`ex-
`cylinder
`metallic
`stent.
`The
`device
`pandable
`through
`an 11-F
`Teflon
`was
`passed
`the
`normal
`abdominal
`catheter
`aortas
`of nine
`dogs.
`or
`thoracic
`of 7-35
`weeks,
`all but
`follow-up
`graft
`remained
`patent.
`At necropsy,
`the
`grafts
`were
`almost
`completely
`covered
`neo-intimal
`prolifera-
`tion.
`proliferation
`was
`served
`the
`graft
`and
`wall
`
`into
`
`by
`Similar
`between
`the
`vessel.
`
`of
`
`At
`one
`
`ob-
`the
`
`terms:
`Index
`#{149}Arteries,
`
`Aorta,
`grafts
`and
`
`and
`grafts
`prostheses,
`
`prostheses,
`94.456
`
`56.45
`
`163:357-360
`
`T HE Gianturco
`
`has
`the
`
`been
`venous
`tree
`
`in
`
`metallic
`successful-
`and
`
`tra-
`indic-
`
`expandable
`placed
`system
`humans,
`expanding
`in
`2). Endovascu-
`(1,
`been
`placed
`with
`stents
`
`also
`animals,
`of
`the
`
`in
`eventual
`into
`the
`
`its
`
`utility
`lumens
`have
`of
`
`(3,
`use
`
`of
`such
`
`4).
`Giantunco
`of
`intravascular
`for
`materials.
`other
`a modification
`placement
`multiple
`
`the
`the
`
`stent
`
`de-
`We
`to
`allow
`a Dacron
`stents
`an-
`a
`
`structed,
`used.
`The
`woven
`proximately
`ally
`5.0
`long).
`to
`the
`with
`ed,
`Ion
`ylene
`
`graft
`Dacron
`
`cm in
`The
`ends
`limbs
`of
`6-0
`suture
`the
`devices
`cartridges
`oxide.
`
`but
`
`wire
`
`of
`
`thinner
`
`gauge
`
`was
`
`were
`tubes
`sheets.
`cm in
`1.0
`length
`the
`of
`lead
`the
`material.
`were
`and
`
`made
`The
`diameter
`(range,
`graft
`and
`
`from
`graft
`was
`and
`2.5-9.5
`were
`trail
`Once
`into
`
`thin,
`ap-
`usu-
`cm
`attached
`stents
`construct-
`12-F
`with
`
`Tef-
`eth-
`
`loaded
`sterilized
`
`gas
`
`Placement
`
`and
`
`Follow-up
`
`Graft
`Study
`
`the
`
`for
`
`stent
`by within
`cheobronchial
`ative
`of
`narrowed
`lan
`stents
`the
`arteries
`incorporation
`vessel
`walls
`Another
`as
`a vehicle
`is
`placement
`veboped
`intravascular
`graft,
`using
`as
`a superstructure
`chon
`and
`support
`device
`may
`find
`of
`aneurysms,
`a new
`lumen
`while
`sealing
`side
`the
`of
`to
`a surgically
`ate
`the
`feasibility
`and
`short-term
`vice,
`we
`studied
`tas
`nine
`dogs.
`
`of
`
`of
`Giantunco
`to
`by which
`Such
`the
`graft.
`treatment
`use
`in
`the
`creation
`it
`allows
`aneurysm
`the
`aneurysm
`a manner
`To
`graft.
`the
`placement
`of
`this
`normal
`
`of
`
`out-
`similar
`evalu-
`
`de-
`
`aor-
`
`the
`
`the
`in
`placed
`of
`patency
`it
`in
`
`as
`within
`off
`device
`
`MATERIALS
`
`AND
`
`METHODS
`
`Stent
`
`Construction
`
`graft
`endovascular
`The
`tandem
`in
`stents
`multiple
`struts.
`by metallic
`other
`each
`the
`lead
`designated
`was
`stent
`(Fig.
`la).
`stent
`trail
`as
`the
`last,
`around
`wrapped
`was
`tubing
`of
`stents,
`group
`of
`the middle
`the Dacron
`ing
`them
`within
`stents
`acted
`lead
`and
`trail
`the
`internal
`the
`graft,
`while
`to open
`the Dacron
`tubing
`vice was
`released
`from
`the
`lc).
`
`of
`
`to
`
`consisted
`connected
`first
`The
`the
`stent;
`The Dacron
`the
`outside
`internaliz-
`graft.
`The
`as anchors
`for
`stents
`served
`when
`the
`de-
`catheter
`(Fig.
`
`lead
`
`The
`structed,
`stainless
`0.016
`no
`side
`mately
`proximately
`The
`internal
`
`trail
`and
`as previously
`with
`steel
`wire
`had
`Each
`stent
`inch.
`barbs.
`The
`stents
`cm long,
`with
`2.5
`2.5
`cm when
`stents
`were
`
`con-
`(3),
`
`of
`
`of
`and
`
`were
`stents
`described
`a diameter
`six
`bends
`were
`approxi-
`of
`a diameter
`fully
`expanded.
`similarly
`con-
`
`Radiology
`
`1987;
`
`Imaging,
`Universi-
`Ander-
`
`of Diagnostic
`the Division
`I From
`Radiology,
`of Diagnostic
`Department
`M.D.
`Center,
`System
`Cancer
`ty of Texas
`Houston.
`Institute,
`and
`Tumor
`son
`Hospital
`Received
`annual
`meeting.
`RSNA
`1986
`From
`the
`8, 1987.
`accepted
`January
`1986;
`10,
`November
`J. S.
`the
`supported
`part
`by
`was
`This
`work
`Foundation
`and
`the George
`Dunn
`Research
`re-
`Cook Memorial
`Fund.
`Address
`reprint
`to D.D.L.,
`Department
`of Radiology,
`quests
`University
`of Texas Medical
`School
`at Houston,
`6341
`Fannin,
`Suite
`2130 MSMB,
`Houston,
`TX
`77030.
`#{176}RSNA, 1987
`
`in
`
`A.
`
`ten
`and
`diate
`the
`cally.
`The
`
`Aontography
`graft
`placement
`prior
`to death
`or delayed
`graft
`placement
`
`was
`
`performed
`in
`the
`first
`in all
`dogs.
`complications
`were
`
`1 week
`six
`dogs
`No
`imme-
`related
`
`af-
`
`to
`
`observed
`
`clini-
`
`exsanguina-
`killed
`were
`dogs
`anesthesia
`pentobarbital
`deep
`under
`tion
`(four
`dogs),
`8 weeks
`(two
`7 weeks
`at
`(one
`16, and
`35 weeks
`at
`dogs),
`and
`the
`procedure.
`At necrop-
`after
`dog
`each)
`aorta
`containing
`of
`sy,
`the
`section
`graft
`was
`removed,
`together
`with
`neys,
`if
`any
`portion
`of
`the
`device
`bridged
`the
`renal
`arteries.
`
`by
`
`10,
`
`the
`
`the
`kid-
`
`the
`had
`
`RESULTS
`
`ap-
`
`grafts,
`patent
`
`All
`mained
`observation.
`
`one
`with
`during
`There
`
`was
`
`exception,
`the
`periods
`no
`evidence
`
`ne-
`of
`
`357
`
`induction
`intravenous
`dogs
`into
`systemic
`after
`and
`introduction
`stent
`11-F
`was
`Ind.)
`Bloomington,
`abdominal
`into
`the
`normal
`normal
`thoracic
`dogs
`and
`the
`a femoral
`arteniotomy
`by
`Aortography
`was
`performed
`of
`the
`size
`the
`vessel.
`The
`then
`introduced
`through
`released
`under
`fluoroscopic
`and
`the
`technique
`previously
`with
`placement
`of
`a Gianturco
`for
`A second
`arteniogram
`was
`to enable
`evaluation
`of
`the
`postplacement
`results.
`The
`not
`given
`anticoagulants
`were
`following
`graft
`placement
`heparinization
`during
`follow-up
`
`sodium
`of
`general
`hepaniniza-
`assembly
`intro-
`aortas
`aortas
`
`the
`
`then
`im-
`ani-
`rou-
`except
`stud-
`
`dogs
`
`After
`pentobanbital
`anesthesia
`tion,
`an
`(Cook,
`duced
`of
`six
`of
`three
`procedure.
`to
`document
`grafts
`were
`cartridge
`guidance
`described
`stent
`obtained
`mediate
`mals
`tinely
`for
`ies.
`
`(3).
`
`Edwards Lifesciences Corporation, et al. Exhibit 1129, Page 1 of 4
`
`
`
`a.
`Figure
`lead
`sembled
`
`and
`
`1.
`
`(a)
`trail
`device,
`
`Photograph
`stents
`(large
`with
`Dacron
`
`components
`of
`as
`arrows)
`act
`graft
`around
`
`the
`of
`anchors;
`internal
`
`endovascular
`the
`internal
`stents.
`
`(c)
`
`b.
`graft.
`stents
`Device
`
`c.
`
`Array
`(small
`being
`
`of Gianturco
`arrows)
`released
`
`serve
`from
`
`forms
`stents
`to open
`the
`11-F
`sheath
`
`basic
`Dacron
`catheter.
`
`superstructure
`graft
`
`(shown
`
`of
`
`device.
`the
`right).
`
`The
`(b) As-
`
`at
`
`none
`and
`migration,
`graft
`of
`from
`separated
`broke
`or
`stents
`the
`along
`Perforation
`other.
`arch
`aortic
`the
`of
`curvature
`occurred
`stent
`a lead
`prong
`suffered
`animal
`neither
`animals;
`subsequent
`effect,
`adverse
`extravasation.
`showed
`grams
`it was
`study
`arteniognaphic
`At
`1 mm
`of
`approximately
`that
`immediately
`narrowing
`occurred
`device;
`this
`placement
`of
`the
`related
`the
`thickness
`the
`of
`graft
`itself.
`Further
`luminal
`between
`1 and
`3 mm
`oc-
`of
`the
`Dacron
`graft
`the
`follow-up
`periods.
`side
`branches
`of
`the
`the
`where
`while
`metallic
`(Fig.
`dis-
`found
`vessel
`
`of
`
`ed
`nal
`after
`was
`Dacron
`narrowing
`the
`region
`cunned
`oven
`of
`Occlusion
`observed
`ta was
`the
`Dacron
`branches
`side
`stents
`alone
`On
`gross
`sected
`grafts,
`to be
`firmly
`
`and
`no
`
`to
`
`in
`was
`graft
`bridged
`remained
`examination
`the
`devices
`adherent
`
`areas
`present,
`the
`by
`patent
`the
`of
`were
`the
`
`to
`
`of
`
`the
`each
`distal
`by
`a
`in
`
`two
`any
`aorto-
`
`not-
`lumi-
`
`in
`
`aor-
`
`2).
`
`A thin
`wall.
`over
`observed
`while
`stents,
`present
`was
`material.
`graft
`nearly
`was
`and
`graft
`continuous
`most
`cases.
`The
`Dacron
`in
`were
`larger
`were
`tive
`lumen,
`inside
`“pleated”
`spaces
`This
`created
`the
`cron
`graft
`with
`that
`were
`similar
`sue
`response
`the
`of
`side
`the
`lumen
`Dacron
`pleating
`of
`the
`response
`timal
`growth
`a smooth
`production
`thicker
`the
`covering
`branches
`The
`side
`stents
`trail
`a neo-intimal
`
`translucent
`the
`a much
`inside
`The
`complete
`the
`metallic
`with
`the
`
`lead
`
`covering
`and
`trail
`thicken
`covering
`lumen
`of
`the
`of
`covering
`both
`the
`and
`was
`intima
`
`was
`
`in
`
`the
`extent
`over
`stents
`native
`
`grafts,
`than
`diameter
`longitudinally
`the
`vessel
`between
`vessel
`native
`proliferative
`to
`that
`seen
`graft.
`With
`graft,
`neo-in-
`resulted
`in
`lumen,
`with
`the
`crevices.
`in
`bridged
`by
`remained
`patent
`covering
`
`most
`
`of which
`the
`
`na-
`
`lumen.
`the
`
`Da-
`wall
`
`tis-
`in-
`
`the
`
`on
`
`and
`filled
`
`of
`
`on
`
`lead
`without
`
`Examination
`cases
`these
`emboli
`of
`in which
`the
`Dacron
`by
`infarction
`of
`supplied
`vessel
`filled
`Lumbar
`bridged
`organized
`3).
`(Fig.
`study,
`covered
`of
`
`wines.
`in
`
`the
`neys
`evidence
`two
`cases
`bridged
`showed
`the
`kidney
`with
`the
`thrombus.
`branches
`contained
`their
`At
`found
`ative
`process
`7 weeks,
`that
`the
`The
`stages
`nected
`fibnin
`fibnoblasts
`of
`fibnocytes
`
`to
`
`cells
`seen
`grafts.
`
`resembling
`at
`the
`An
`
`luminal
`area
`of
`
`of
`
`the
`by
`by
`
`and
`by
`
`the
`no
`showed
`or
`infarction.
`a renal
`artery
`portion
`portion
`the
`artery,
`organized
`intercostal
`Dacron
`the
`thrombus
`
`kid-
`gross
`The
`was
`
`of
`
`also
`
`in
`
`was
`
`The
`at
`time
`
`con-
`a few
`layers
`A layer
`was
`the
`metapla-
`
`of
`
`of
`
`by
`various
`well
`was
`
`origins
`graft
`the
`histologic
`fibnopnolifen-
`to
`be
`degrees.
`changes
`established
`appeared
`earliest
`the
`which
`examined.
`were
`specimens
`a loosely
`from
`ranged
`containing
`layer
`packed
`densely
`and
`collagen.
`endothelium
`surface
`chondroid
`
`358.
`
`Radiology
`
`May
`
`1987
`
`Edwards Lifesciences Corporation, et al. Exhibit 1129, Page 2 of 4
`
`
`
`a.
`Figure
`tween
`(short
`shows
`
`2.
`two
`arrow)
`lead
`
`b)
`(a,
`long
`of
`stent
`
`b.
`Dacron
`graft.
`endovasculam
`of
`placement
`after
`8 weeks
`of dog
`aortogram
`lateral abdominal
`from
`proliferation.
`of the graft as a result of neo-intimal
`is mild
`luminal
`narrowing
`in the region
`of L-5 lumbar
`arteries by the graft, with
`reconstitution
`by collaterals. (c) Anteropostemion
`aortogram
`left
`renal
`artery
`but
`not
`occluding
`it.
`
`c.
`
`is be-
`portion
`occlusion
`same
`animal
`
`Note
`of
`
`observed
`The
`appear
`that
`dense
`7 weeks,
`
`the
`
`as
`
`at
`was
`the
`
`to
`
`in
`
`in
`
`several
`
`sia was
`one
`graft.
`did
`not
`of
`time
`place,
`seen
`tion
`various
`and
`in
`the
`served
`recanalization
`present
`Stenosis
`duce
`oped
`related
`which
`other
`caudal
`fully,
`ternal
`botic
`of
`two
`35 weeks)
`the
`other
`The
`
`the
`not
`
`in
`
`two
`of
`to
`use
`occl
`nearly
`caused
`was
`of
`end
`as
`it was
`stent.
`vegetations
`the
`devices
`but
`grafts.
`Dacron
`
`the
`
`of
`related
`had
`
`loose
`at
`
`neo-intima
`organization
`to
`length
`been
`in
`could
`organiza-
`35 weeks,
`could
`be
`Evidence
`graft.
`neo-intima
`
`of
`
`be
`
`ob-
`of
`
`was
`4).
`(Fig.
`pro-
`to
`devel-
`was
`
`enough
`coblatenals
`One
`stenosis
`oversized
`the
`failure
`
`to
`
`organized
`present
`7 weeks
`seen
`
`not
`
`graft,
`aorta.
`the
`of
`open
`in-
`by
`an
`throm-
`on
`and
`any
`
`The
`
`at
`of
`
`in
`
`dogs
`easily
`
`of
`was
`catheter
`the
`that
`branches
`ducing
`seen
`11).
`wines
`without
`This
`the
`ies,
`phabic
`bevel
`the
`between
`intima
`aneurysm
`lifenative
`experiments
`Most
`tion,
`bated
`tentially
`attention
`
`the
`graft
`filled,
`may
`tissue
`
`the
`
`of
`stenosis)
`to
`technical
`avoidable
`to
`graft
`
`our
`that
`demonstrates
`an
`through
`placed
`It was
`vessel.
`into
`the
`the
`side
`grafts
`occluded
`as well
`they
`bridged
`similar
`a neo-intima
`placed
`surgically
`in
`bridged
`vessels
`The
`alone
`demonstrated
`evidence
`of
`feature
`will
`allow
`lead
`stent
`across
`permitting
`placement
`graft
`portion
`of
`the
`artery.
`of
`renal
`and
`the
`wall
`was
`suggesting
`in with
`fill
`response.
`evaluate
`will
`complications
`that
`occurred
`and
`factors
`careful
`by
`placement
`
`the
`
`grafts
`by
`stent
`patency
`embobi.
`distal
`placement
`renal
`of
`just
`
`design
`11-F
`shown
`
`to
`
`as
`that
`(5-
`
`pro-
`
`of
`
`arter-
`the
`ce-
`below
`Space
`the
`native
`that
`the
`a fibropro-
`Our
`future
`this.
`(perfora-
`were
`are
`
`re-
`po-
`
`and
`
`to
`
`development
`produce
`was
`to
`by
`placed
`treat
`to
`pass
`should
`catheter
`small
`of
`lumen
`device
`the
`way
`same
`providing
`flow
`and
`vascular
`evaluation
`in
`normal
`
`of
`
`a
`an
`
`the
`a
`
`an-
`
`the
`
`as
`
`a
`
`a
`sup-
`wall.
`of
`the
`aortas
`
`main
`heat
`before
`weeks
`found
`olateral
`estingby,
`with
`
`disrupted
`had
`patent
`autoclaving
`inadvertent
`from
`necropsy,
`At
`insertion.
`the
`after
`placement,
`against
`to
`be
`layered
`vessel
`wall
`of
`the
`was
`completely
`neo-intima.
`
`been
`
`by
`
`16
`
`was
`anten-
`inter-
`
`graft
`the
`and,
`covered
`
`DISCUSSION
`
`the
`graft
`be
`could
`approach
`device
`The
`a relatively
`to
`fit
`
`in
`
`expand
`When
`then
`
`goal
`The
`endovasculan
`device
`that
`transcatheter
`eurysm.
`through
`the
`and
`place,
`in
`vessel.
`in
`the
`act
`should
`graft,
`placed
`surgically
`blood
`for
`new
`conduit
`weakened
`porting
`the
`Our
`preliminary
`endovascular
`
`that
`
`did
`
`not
`
`re-
`
`device
`
`Volume
`
`163
`
`2
`
`Radiology.
`
`359
`
`Edwards Lifesciences Corporation, et al. Exhibit 1129, Page 3 of 4
`
`
`
`tailoring
`the
`vascular
`vegetation
`bothersome
`ation.
`While
`
`the
`
`graft
`lumen.
`two
`
`on
`and
`
`to
`
`of
`needs
`
`the
`The
`the
`
`diameter
`presence
`stents
`further
`
`of
`of
`
`is
`evalu-
`
`this
`
`endovasculan
`
`graft
`
`was
`
`designed
`aneurysms,
`ments
`plasty
`nous
`systems.
`
`primarily
`other
`
`include
`adjunct
`system
`
`its
`and
`and
`
`U
`
`evaluation
`for
`expeni-
`potential
`a postangio-
`use
`as
`as
`stents
`in
`the
`other
`organ
`
`in
`
`ye-
`
`We
`Acknowledgments:
`Collins,
`R. 1.,
`and
`Raquel
`assistance,
`able
`technical
`for
`and
`Jay
`Johnson
`grateful
`to L. Clifton
`for
`reviewing
`and
`ic specimens
`and
`help.
`
`thank
`B.S.,
`and
`photography.
`Stephens,
`photographing
`to Katie
`Isch
`
`Szwarc,
`Irene
`invalu-
`for
`their
`John
`Kuykendahl
`We
`are
`D.V.M.,
`Ph.D.,
`the
`histolog-
`secretarial
`
`for
`
`of
`
`in
`work
`
`KC, Wallace
`CH,
`Gianturco
`stents:
`1985;
`JC, Windeler
`RR, Reuter
`expandable
`1986;
`
`2.
`
`3.
`
`4.
`
`5.
`
`6.
`
`7.
`
`CH, Wallace
`cava:
`preliminary
`with
`expandable
`1986;
`161:295-298.
`K.
`C, Ogawa
`metallic
`expandable
`clinical
`and
`Radiology
`
`S, et
`as-
`
`me-
`
`et
`
`al.
`
`ap-
`1986;
`
`C, Car-
`endo-
`evaluation.
`
`F, Tio
`
`grafting.
`
`FO,
`rabbit
`Ra-
`
`S. Kata-
`process
`a morpho-
`J Sung Res
`
`non-
`
`Da-
`femoropo-
`In: Wright
`applica-
`Wright-
`
`R,
`J.
`
`Jersild
`Seeding
`endothelium.
`
`Jr.,
`RA,
`arterial
`Ann
`
`Boxer
`pros-
`Sung
`
`L,
`
`References
`1 .
`C, Carrasco
`Charnsangavej
`the
`vena
`of
`al.
`Stenosis
`treatment
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`stents.
`tallic
`MJ, Charnsangavej
`Wallace
`Tracheobronchial
`tree:
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`used
`experimental
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`in
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`158:309-312.
`S. Charnsangavej
`Wright
`C.
`Percutaneous
`rasco
`experimental
`an
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`SA, Garcia
`Palmaz
`Atherosclerotic
`SR.
`Sibbitt
`intraluminal
`aortas:
`160:723-726.
`diology
`M, Namba
`J, Kamatani
`Takebayashi
`reparative
`gami
`Y. Hayashi
`K.
`Early
`of
`implanted
`arterial
`prosthesis:
`logical
`and
`hematological
`study.
`1974; 17:102-110.
`supported,
`Sauvage
`LR.
`Externally
`weft-knitted
`crimped,
`external-velour,
`axillofemoral,
`cron
`prosthesis
`for
`bypass.
`pliteal.
`and
`femorotibial
`clinical
`CB,
`ed. Vascular
`grafting:
`tions
`and
`techniques.
`Boston:
`John
`I)sG,
`1983;
`168-186.
`Herring
`MB,
`Dilley
`Gardner
`A, Clover
`theses
`with
`vascular
`1979; 190:84-90.
`Mason
`RC.
`The
`static
`elements
`Hemost
`Thromb
`Warren
`BA, Brock
`scopic
`features
`and
`“neo-intima.”
`Br
`617.
`MB.
`Herring
`In: Wright
`flow.
`applications
`clinical
`Wright-PSG,
`John
`LR, Berger
`Sauvage
`JC, Mansfield
`Smith
`of
`porous
`arterial
`109:698-705.
`
`hemo-
`Prog
`
`blood
`of
`interaction
`surfaces.
`with
`artificial
`1972; 1:141-164.
`micro-
`LC.
`The
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`fibninolytic
`properties
`J Exp Pathol
`1964;
`45:612-
`
`of
`
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`Endothelial
`CB,
`ed. Vascular
`and
`techniques.
`1983;
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`SJ, Yates
`KE, Wood
`PB.
`Interspecies
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`Arch
`
`blood
`of
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`Boston:
`
`SG,
`healing
`1974;
`
`Sung
`
`8.
`
`9.
`
`10.
`
`1 1 .
`
`a.
`Figure
`ing
`of
`artery.
`the
`are
`
`of device
`specimen
`(a) Gross
`3.
`(b) Gross
`neo-intima.
`device
`by
`the
`and
`there
`vessel
`remains
`patent,
`The
`Dacron
`graft
`bridging
`the
`artery.
`The
`wire
`completely
`covered
`with
`neo-intima.
`
`b.
`
`in
`
`abdominal
`specimen
`is no
`and
`
`aorta.
`shows
`neo-intimal
`its
`junction
`
`There
`lead
`
`stent
`covering
`with
`
`the
`
`complete
`is nearly
`bridging
`wire
`oven
`the
`native
`
`cover-
`renal
`of
`(arrow)
`
`left
`portion
`vessel
`
`a.
`Figure
`minal
`in
`the
`atively
`neo-intima
`ma.
`
`4.
`surface.
`neo-intima
`more
`
`filling
`and
`in
`
`(a) Photomicrogmaph
`A layer
`of
`cells
`represent
`by
`the
`
`of cross
`resembling
`a cross
`section
`neo-intima
`in
`the
`fibnoproliferative
`
`360
`
`. Radiology
`
`section
`endothelium
`through
`the
`valleys,
`response
`
`of abdominal
`seen
`is
`internal
`attempt
`the
`
`the
`
`in
`between
`
`b.
`
`aorta
`at
`the
`stent
`to
`Dacron
`
`shows
`luminal
`wires.
`produce
`graft
`
`(short
`the
`
`graft
`of
`
`Dacron
`surface
`(b)
`“Pleated”
`an
`even
`luminal
`and
`the
`native
`
`arrow)
`neo-intima
`graft
`has
`surface.
`vessel.
`
`covered
`(long
`longitudinal
`There
`Arrow
`
`neo-intima
`by thick
`The
`large
`arrow).
`and
`valleys.
`peaks
`recanalization
`region
`
`to
`
`of
`
`the
`
`is also
`points
`
`lu-
`on its
`smooth
`holes
`mel-
`the
`inti-
`
`Note
`within
`native
`
`May
`
`1987
`
`Edwards Lifesciences Corporation, et al. Exhibit 1129, Page 4 of 4
`
`