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

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Presentation on theme: "The Multilayer Flow Modulator stent for the treatment for arterial aneurysms: Concept, Indications and Contraindications  Michel Henry, Amira Benjelloun,"— Presentation transcript:

1 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 (May 2016) DOI: /j.jicc Copyright © Terms and Conditions

2 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: ( /j.jicc ) Copyright © Terms and Conditions

3 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: ( /j.jicc ) Copyright © Terms and Conditions

4 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: ( /j.jicc ) Copyright © Terms and Conditions

5 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: ( /j.jicc ) Copyright © Terms and Conditions

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

7 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: ( /j.jicc ) Copyright © Terms and Conditions

8 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: ( /j.jicc ) Copyright © Terms and Conditions

9 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: ( /j.jicc ) Copyright © Terms and Conditions

10 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: ( /j.jicc ) Copyright © Terms and Conditions

11 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: ( /j.jicc ) Copyright © Terms and Conditions

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

13 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: ( /j.jicc ) Copyright © Terms and Conditions

14 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: ( /j.jicc ) Copyright © Terms and Conditions

15 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: ( /j.jicc ) Copyright © Terms and Conditions

16 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: ( /j.jicc ) Copyright © Terms and Conditions

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

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