Multilayer flow modulator stent technology: a treatment revolution for US patients?

Sultan, Sherif; Hynes, Niamh

doi:10.1586/17434440.2015.1030339

Cited by 15 publications

(12 citation statements)

References 22 publications

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“…These results suggest that control of the hemodynamic parameters inside the sac cannot be achieved by intuitively setting the stent porosity, requiring a CFD tool to predict the hemodynamic environment. Currently, there are no clinical practice guidelines to specify which type of porous stent is most efficacious for reducing the AAA progression without increasing the risk of rupture 39 . Therefore the proposed methodology is needed to inform these decisions and to improve clinical outcomes from treatments using porous stents in complex AAAs.…”

Section: Resultsmentioning

confidence: 99%

Optimization of porous stents for endovascular repair of abdominal aortic aneurysms

Stockle

Romero

Amón

2020

Numer Methods Biomed Eng

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This study presents a simulation‐based methodology to design porous stents to induce suitable hemodynamic environments inside abdominal aortic aneurysm (AAA) sacs. In the proposed methodology, an optimization algorithm iteratively modifies the porosity distribution of the stent and executes a computational fluid dynamics (CFD) simulation to determine the effect of these changes on the hemodynamic conditions inside the aneurysm sac. The optimization iterations proceed until relevant hemodynamic parameters are within ranges prescribed a priori by the user as desirable to control the progression of the AAA. The resulting porosity distribution uniquely describes the porous stent design that can control the hemodynamic environment (eg, shear stress at the aneurysm wall, pressure distribution, residence time), reducing AAA rupture risks and improving treatment efficacy. To demonstrate its potential, the proposed methodology is applied to idealized AAA geometry under steady‐state flow conditions, though it may be easily applied to more complex AAA geometries under transient, pulsatile flow conditions. The proposed methodology has the potential to enable the design of a new generation of porous stents tailored to patient‐specific geometries and flow conditions, to improve patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Optimization of porous stents for endovascular repair of abdominal aortic aneurysms

Stockle

Romero

Amón

2020

Numer Methods Biomed Eng

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“…It is designed to modulate blood-flow dynamics by relieving local peak wall shear stress (PWSS), achieving stabilization of aneurysm-sac or false lumen pressure and preserving branches patency. Aneurysm rupture is prevented while flow lamination allows for both aneurysm thrombosis and branch perfusion (14,15). The present study offers early-and mid-term results on 8 patients with complex iliac artery aneurysms treated with MFM.…”

Section: Introductionmentioning

confidence: 82%

“…The MFM is a new, unique device which is used for the treatment of complex aneurysms. Its usage has increased with time and is being more frequently reported in the literature (12)(13)(14)(15). In this study, we presented our early-and mid-term results on 8 patients treated with the MFM for IAA.…”

Section: Discussionmentioning

confidence: 99%

Kompleks İliak Arter Anevrizmalarında Çok Katmanlı Akış Modülatörü Kullanımı

Ovalı¹,

Dernek²

2018

Osmangazi̇ Journal of Medicine

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We are presenting early-and mid-term results of iliac artery aneurysms treated with the Multilayer Flow Modulator (MFM). The MFM was used to treat 14 aneurysms involving the internal and external iliac arteries (complex iliac artery aneurysm). The procedure was performed under local anesthesia implemented through femoral artery under local anesthesia. The effective implantation of MFM within the aneurysmal area without complications was defined as a successful intervention. The patients were followed for the development of clinical events during 12 months. A total of 8 out of 14 aneurysms were presented with complex iliac artery aneurysm and they were successfully treated using MFM. While iliac artery aneurysm was bilateral in six patients, it was unilateral in two patients. In addition, 6 patients were male and two patients were female with average age of 64 years ranging from 56 to 72 years. Type 1 endoleak occurred in one patient. Endovascular re-intervention ballooning was performed (ballooning) and the endoleak was successfully treated. The creatinine level increased to 2.1 mg/dl on the 2nd postoperative day in one of the patients but the patient did not need any dialysis and his kidney functions returned to normal on the 7th day after the operation. Moreover, right iliac artery occlusion occurred in one of the patients on the 30th day after the operation and the occlusion was treated with thrombectomy followed by ballooning and stenting. No other complications developed either during or after the procedure. MFM stents appeared to be effective and safe in the treatment of complex iliac artery aneurysms. Our results need to be supported by larger and longer-term follow-up studies.

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“…There was no paraplegia in this group of patients and no paraplegia or other spinal cord ischaemia after covering the intercostal artery, as permanent paraplegia after TEVAR is associated with the length of the thoracic aorta covered. Feezor et al [6] found that spinal cord ischaemia after TEVAR occurred when the distance between the stent graft and the proximal end of the abdominal cavity was 17.3 ± 21.8 mm, whereas no ischaemia was observed when the distance was 63.1 ± 62.9 mm (p = 0.0006). The coverage length threshold was 205 mm, and the sensitivity and specificity of predicting spinal cord ischaemia after TEVAR were 80 and 92.5%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Application of a new blood flow regulator in aortic endovascular therapy

Liu

Xue

Wang

et al. 2020

J Cardiothorac Surg

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Background: Endovascular repair involving branches of the aorta is still difficult in clinical treatment. A new type of blood flow regulator has been used in thoracic endovascular aortic repair/endovascular aortic repair in our centre, and the effects were followed and analysed.Methods: From March 2014 to January 2015, 14 patients with Stanford type B aortic dissection or penetrating ulcers and aortic arch pseudoaneurysms were consecutively enrolled. All patients were evaluated and underwent endovascular repair. The average age of these patients was 59 ± 14 years (34-76 years old, median 62 years), and there were 12 males and 2 females. The blood flow regulator was a self-expanding membrane-supported artificial blood vessel. The film was made from polyester that was formed into a mesh 1 mm 2 in size. The metal stent used was made of nickel-titanium alloy. Results: The success rate for the technique was 100%. All patients underwent postoperative aortic CTA and had type III endoleak. There were no deaths and no instances of stroke, transient ischemic attack (TIA), hemiplegia, paraplegia or other central nervous system complications, and there were no left upper limb ischaemia symptoms in the group. The average follow-up time was 14.7 ± 3.6 months. One patient died of sudden death 4 months after the operation. One patient died due to abdominal aortic aneurysm rupture, and the other 12 patients survived. The survival rate was 86%. The blood flow regulator covered a total of 19 branch vessels (the intercostal artery was not counted), of which 18 experienced smooth blood flow. One patient continued to have a type III endoleak after the operation, and the endoleak disappeared after endovascular repair. Conclusions:This clinical case series of 14 patients with percutaneous transluminal stents indicates that the blood flow regulator is safe and feasible in TEVAR surgery, providing a promising new technology.

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Multilayer flow modulator stent technology: a treatment revolution for US patients?

Cited by 15 publications

References 22 publications

Optimization of porous stents for endovascular repair of abdominal aortic aneurysms

Optimization of porous stents for endovascular repair of abdominal aortic aneurysms

Kompleks İliak Arter Anevrizmalarında Çok Katmanlı Akış Modülatörü Kullanımı

Application of a new blood flow regulator in aortic endovascular therapy

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