The Multilayer Flow Modulator stent for the treatment for arterial aneurysms: Concept, Indications and Contraindications Michel Henry, Amira Benjelloun,

Slides:

Advertisements

Similar presentations

Otikunta Adikesava Naidu, S.A.A. Latheef, Y.V. Subba Reddy

Advertisements

Multi-layer Flow-modulating Stents for Thoraco-abdominal and Peri-renal Aneurysms: The UK Pilot Study C. Lowe, A. Worthington, F. Serracino-Inglott,

Celiac artery coverage after occlusion test during endovascular stent grafting for thoracoabdominal aortic aneurysm Taro Shimazaki, MD, Satoshi Kawaguchi,

A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending.

Custom-made versus off-the-shelf multibranched endografts for endovascular repair of thoracoabdominal aortic aneurysms Theodosios Bisdas, MD, Konstantinos.

The use of multilayer flow modulators in the endovascular treatment of complex aortic aneurysms and aortic dissections V. Costache, R. Hulpus, A. Costache,

Bifurcation aortic stent graft placement in a patient with abdominal aortic aneurysm and single kidney with renal artery stenosis G. Ramesh, M. Sandeep

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD

Hybrid approach to thoracoabdominal aortic aneurysms in patients with prior aortic surgery Roberto Chiesa, MD, Yamume Tshomba, MD, Germano Melissano,

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture Felix J.V. Schlösser, MD, PhD, John E. Aruny,

Reply Journal of Vascular Surgery

Aortic stent-graft for patent ductus arteriosus in adults: the aortic exclusion technique François Roques, MD, Jean-Luc Hennequin, MD, Bruno Sanchez,

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients Joseph.

Elective sac perfusion to reduce the risk of neurologic events following endovascular repair of thoracoabdominal aneurysms Seamus C. Harrison, MRCS,

Periscope graft to extend distal landing zone in ruptured thoracoabdominal aneurysms with short distal necks Zoran Rancic, MD, PhD, Thomas Pfammatter,

A late diagnosis of aortic coarctation began as an acute coronary syndrome Gregory Dendramis, Claudia Paleologo, Pasquale Assennato, Salvatore Novo Journal.

Thoracoabdominal and coronary arterial aneurysms in a young man with a history of Kawasaki disease Mladen Petrunić, MD, PhD, Nikša Drinković, MD, PhD,

Technical aspects, current indications, and results of chimney grafts for juxtarenal aortic aneurysms Raphael Coscas, MD, Hicham Kobeiter, MD, Pascal.

Left coronary sinus of Valsalva aneurysm ruptured into the left ventricle – Case report Ajit Desai, Nihar Mehta, Vivek Mandurke, Sanjeev Vichare, Anmol.

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD

Sang-Jun Park, MD, Mi-Na Kim, MD, Tae-Won Kwon, MD, PhD

Early versus late experience in fenestrated endovascular repair for abdominal aortic aneurysm Magnus Sveinsson, MD, Jonathan Sobocinski, MD, PhD, Timothy.

Beware of Infection Before Treating Aneurysms with Stent-grafts

Type IV Thoraco-Abdominal Aortic Aneurysm (TAAA IV) with Occlusion of Celiac and Superior Mesenteric Arteries in a High Risk Patient: Successful Treatment.

Late Gore Excluder endoprosthesis fabric tear leading to abdominal aortic aneurysm rupture 5 years after initial implant Anand Dayama, MD, Nikolaos Tsilimparis,

Total videoscopic treatment of a type IV thoracoabdominal aneurysm

Coral Reef Aorta: Case Reports and Review of the Literature

Posterior reversible encephalopathy syndrome from induced hypertension during endovascular thoracoabdominal aortic aneurysm repair Gustavo S. Oderich,

Preoperative assessment of abdominal aortic aneurysm: The value of helical and three- dimensional computed tomography Mario N. Gomes, MD, William J. Davros,

Management of a rapidly expanding celiac artery aneurysm with the chimney technique Andreia Coelho, MD, Pedro Monteiro, MD, Clara Nogueira, MD, Ricardo.

Multiple overlapping uncovered stents as an alternative flow-diverting strategy in the management of peripheral and visceral aneurysms Yongxue Zhang,

Simplified hybrid repair with true lumen recycling for retrograde renovisceral perfusion in a complex chronic aortic dissection Ricardo Castro-Ferreira,

A new staged hybrid total arch repair procedure using a branched proximal elephant trunk technique with implantation of stent grafts to the ascending.

Successful surgical treatment of multilevel aortic aneurysms combined with renal transplantation Ivan Matia, MD, PhD, Jan Pirk, MD, PhD, Květoslav Lipar,

Experience with a novel custom-made fenestrated stent graft in the repair of juxtarenal and type IV thoracoabdominal aneurysms Alexander E. Rolls, MRCS,

Ruptured Aneurysm Caused by an Endoleak 29 Months After Transluminal Endovascular Grafting for a Dissecting Aortic Aneurysm S. Suzuki, K. Imoto, K. Uchida,

Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV Britt H. Tonnessen, MD, W. Charles Sternbergh, MD, Krishna.

Carlos E. Donayre, MD, Christopher K. Zarins, MD, Dainis K

Successful treatment of disseminated intravascular coagulation associated with aortic dissection Masahiko Fujii, MD, Hiroyuki Watanabe, MD, Masayoshi.

Paraplegia prevention branches: A new adjunct for preventing or treating spinal cord injury after endovascular repair of thoracoabdominal aneurysms Christos.

K. Koseoglu, B. Cildag, S. Sen, M. Boga, M. Parildar EJVES Extra

Successful treatment of disseminated intravascular coagulation associated with aortic dissection Masahiko Fujii, MD, Hiroyuki Watanabe, MD, Masayoshi.

The sandwich technique to treat complex aortoiliac or isolated iliac aneurysms: Results of midterm follow-up Armando C. Lobato, MD, PhD, Luciana Camacho-Lobato,

Aortic treatment of native infection by reconstruction with the Omniflow II biologic prosthesis Majid Harmouche, MD, PhD, Frederic Loreille, MD, Florent.

Gorav Ailawadi, MD, Asheesh Bedi, BS, David M. Williams, MD, James C

Reply Journal of Vascular Surgery

Treatment of an early type II endoleak causing hemorrhage after endovascular aneurysm repair for ruptured abdominal aortic aneurysm Olivier Hartung,

Endovascular repair of bilateral common iliac artery aneurysms following open abdominal aortic aneurysm repair with preservation of both hypogastric arteries.

Ruptured Thoracoabdominal Aneurysm Treatment With Modified Chimney Stent Graft Mario Marino, MD, Holta Kasemi, MD, Costantino Luca Di Angelo, MD, Gian.

Endovascular treatment of thoracoabdominal aortic aneurysms

Late neurological recovery of paraplegia after endovascular repair of an infected thoracic aortic aneurysm Barend M.E. Mees, MD, PhD, Frederico Bastos.

One-year follow-up after total endovascular repair of a contained-ruptured thoracoabdominal aortic aneurysm with the sandwich technique Theodosios Bisdas,

Severe visceral ischemia and death after multilayer stent deployment for the treatment of a thoracoabdominal aortic aneurysm Rafael Noronha Cavalcante,

Pan-aortic hybrid treatment of mega-aorta syndrome

Aortic arch rupture after multiple multilayer stent treatment of a thoracoabdominal aneurysm Emanuele Ferrero, MD, Lorenzo Gibello, MD, Michelangelo.

Jae Woong Lim, MD, Chang Woo Choi, MD, Keun Her, MD, Hwa Kyun Shin, MD

Endovascular management of thoracic aortic aneurysms

Long-segment thoracoabdominal aortic coarctation in a child with Down syndrome Vladimir Tonello de Vasconcelos, MD, Ruy Guilherme Rodrigues Cal, MD, Adriano.

Late renal artery stent fracture with pseudoaneurysm after fenestrated endovascular abdominal aortic aneurysm repair Shanil M. Yapa, MSc, MBBS, Kishore.

Michel Lacombe, MD Journal of Vascular Surgery

Branch graft patency after open repair of thoracoabdominal aortic aneurysms Nicholas T. Kouchoukos, MD, Alexander Kulik, MD, MPH, Catherine Castner, RN,

A new concept in distal arch aneurysm repair with a stent graft

Hazim J Safi, MD, Charles C Miller, PhD The Annals of Thoracic Surgery

Sukgu M. Han, MD, Warren J. Gasper, MD, Timothy A.M. Chuter, MD

The double two-chimney technique for complete renovisceral revascularization in a suprarenal aneurysm Jip L. Tolenaar, MD, Herman J.A. Zandvoort, MD,

Sang-Jun Park, MD, Mi-Na Kim, MD, Tae-Won Kwon, MD, PhD

Aortic treatment of native infection by reconstruction with the Omniflow II biologic prosthesis Majid Harmouche, MD, PhD, Frederic Loreille, MD, Florent.

A staged replacement of the entire aorta from the ascending arch to the hypogastric arteries using a hybrid approach Juan Carlos Jimenez, MD, Wesley.

Retrograde ascending Stanford B aortic dissection complicating a routine infrarenal endovascular aortic reconstruction Apostolos T. Mamopoulos, MD, Thomas.

How to size the main aortic endograft in a chimney procedure

Presentation transcript:

The Multilayer Flow Modulator stent for the treatment for arterial aneurysms: Concept, Indications and Contraindications Michel Henry, Amira Benjelloun, Isabelle Henry Journal of Indian College of Cardiology Volume 6, Pages 26-36 (May 2016) DOI: 10.1016/j.jicc.2015.11.005 Copyright © 2016 Terms and Conditions

Fig. 1 The MFM: (A) a diagram of the 3D geometry of the MFM and (B) the MFM self expandable stent. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 2 Saccular aneurysm without branch. The MFM:• Removes the stress from the neck• Inverses the flow• Breakdowns and reduces the vortex velocity by 90%Immediate thrombosis of the aneurysm. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 3 Saccular aneurysm with branch. The MFM:• Channeled the flow to the branch• Allows for physiological shrinkage while preserving collateral Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 4 Fusiform aneurysm with the two pressures: systemic pressure and local pressure of the vortex. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 5 Fusiform aneurysm: without MFM and with MFM. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 6 Fusiform aneurysm. The MFM:- Eliminates the damaging flow vortex pressurePrevents the risk of aneurysmal rupture- Laminates and redirects its flow along the wallPhysiological organized thrombus- Directs and increases the flow in the branchCollateral branches remain patentProgressive shrinkage of the aneurysm Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 7 A large (∅ 45mm) saccular aneurysm of the right renal artery 3 month follow-up. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 8 Left iliac aneurysm. (A, B) Pre-op. CT scan. (C, D) Result at 3 weeks. (E) Result at 1 year: the aneurysm is totally thrombosed. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 9 Popliteal aneurysm. (A) Pre-op. angiography. (B) Duplex scan at day 1: the aneurysm is almost totally thrombosed. (C) Result at 1 year: the aneurysm is totally thrombosed, the artery well patent. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 10 Right subclavian aneurysm. (A) Pre-op. angiography. (B) CT scan at 3 months. (C, D) Angiographic control at 3 months: the aneurysm is totally thrombosed, the vertebral artery well patent. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 11 Thoraco abdominal aortic aneurysm (TAAA). Treatment with MFM; results at 1 year. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 12 (A) At age 16, angiography showed voluminous thoracoabdominal aneurysms: 4 saccular in the descending and suprarenal aorta and 1 fusiform in the suprarenal aorta. (B) The infrarenal graft implanted 4 years earlier for aneurysm rupture is seen in the reconstructed image on the right. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 13 (A) The levels established on the preoperative scan to follow the evolution of the aneurysms after implantation of 2 multilayer stents. (B–D) Serial scans at 6 months, 12 months and 18 months showing regression of some aneurysms and disappearance of others. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 14 Evolution of the aneurysm at different levels after stent implantation. At its widest, the aneurysm at level D7 measured 18.7 mm; the aneurysm was nearly excluded at the 6 and 18-month follow-up. At the D11 level, the 37.8 mm aneurysm was nearly excluded at 6 months. At the D11–D12 level, the fusiform aneurysm measured 37.1mm; at the 6-month follow-up, there was significant reduction in flow but not much in the size of the aneurysm. At 18 months, there was shrinkage of the sac (36.6mm), but the aneurysm was not completely excluded. At the D12 level, perfusion of the 8mm celiac trunk was clearly seen, which may explain why the aneurysm at the D11–D12 level was not completely excluded. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 15 Volume evolution of the aneurysms at 6 months–1 year compared to preoperative volume. Total volume, flow volume, and thrombus volume are decreasing overtime. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions

Fig. 16 Comparison of the Strato and of the Window studies. Journal of Indian College of Cardiology 2016 6, 26-36DOI: (10.1016/j.jicc.2015.11.005) Copyright © 2016 Terms and Conditions