{"id":23022,"date":"2021-03-25T17:09:50","date_gmt":"2021-03-25T16:09:50","guid":{"rendered":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/"},"modified":"2021-04-28T13:31:07","modified_gmt":"2021-04-28T11:31:07","slug":"multilayer-flow-modulator-for-the-treatment-of-taaas","status":"publish","type":"post","link":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/","title":{"rendered":"Multilayer flow modulator for the treatment of TAAAs"},"content":{"rendered":"<p>C. VAISLIC, A. BENJELLOUN, J.-N. FABIANI, J.-F. BONNEVILLE, S. CHOCRON<\/p>\n<h4>Abstract<\/h4>\n<p>Current treatment of thoracoabdominal aneurysms is associated with significant morbidity and mortality. The most feared and devastating complication is paraplegia accompanied by sphincter and posture problems. To try and reduce these complications we have treated patients with multilayer flow modulators which preserve collateral circulation and branch patency. The multilayer flow modulation concept offers a completely novel approach to thoracoabdominal aneurysm treatment. Aneurysms are excluded physiologically rather than mechanically while preserving vital collateral circulation and enhancing branch patency. Here we present the key principles of the hemodynamic flow modulation concept and its application in peripheral aneurysms as well as FIM cases for the treatment of thoracoabdominal aneurysms. The enrollment of a non randomized multi-center trial with the Cardiatis multilayer flow modulator, for thoracoabdominal aortic aneurysm patients, with no alternative treatment, is currently being completed in France.<\/p>\n<p>Mortality following surgical treatment of TAAA averages between 6% and 15% for elective procedures and between 50% to 60% for emergency operations 1-3. With 15% morbidity for elective procedures, complications are often major with significant risk of renal failure and respiratory insufficiency. This prolongs IC time. Paraplegia is the most feared and devastating complication and frequently leads to sphincter and posture problems. In all cases it is a severe invalidity and in France, since the law of 4th March 2002, leads to systematic claims for compensation before the CRCIs (regional medical accident compensation boards). To reduce these complications adjuvant therapies have been proposed: distal aortic perfusion by circulation bypass or passive shunt 4-6 profound general or local hypothermia with circulatory shutdown, drainage of the cephalorachidian fluid, re-attachment of the Adamkiewicz artery or intercostal arteries as well as postoperative surveillance 7, 8. In every interventional cardiovascular reference work, complete chapters are dedicated to this issue, and whole sessions are dedicated to this at international congresses.<\/p>\n<p>The results of endovascular treatment for infrarenal and descending thoracic aortic aneurysms are now comparable with standard open surgical procedure. However, endovascular repair in the thoracoabdominal aorta has been limited due to the complexity of keeping visceral and renal arteries perfused. Attempts are being made to adapt endoluminal stent-grafts by using custom fenestrations and branched grafts. While preliminary data shows concept feasibility, these techniques are still investigational and require highlyskilled endovascular specialists and custom-made devices 7.<\/p>\n<p>Should this device prove to be efficacious, this type of intervention could readily become more available to patients, due to the device\u2019s ease of use and its ability to be used by more medical professionals (including vascular surgeons and interventional radiologists) than the treatment alternatives.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone wp-image-22655 size-full\" src=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-article.jpg\" alt=\"\" width=\"400\" height=\"310\" srcset=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-article.jpg 400w, http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-article-300x233.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><br \/>\n<strong><em>Fig. 74.2. \u2013 Branching renal aneurysms treated with Cardiatis Multilayer Flow Modulator.<\/em><\/strong><\/p>\n<p><img decoding=\"async\" class=\"alignnone wp-image-22656 size-full\" src=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-2.jpg\" alt=\"\" width=\"400\" height=\"278\" srcset=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-2.jpg 400w, http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-2-300x209.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><br \/>\n<strong><em>Fig. 74.3. \u2013 FU 6 months \u2013 exclusion of aneurysm and perfused collaterals and patent branches.<\/em><\/strong><\/p>\n<p><img decoding=\"async\" class=\"alignnone wp-image-22657 size-full\" src=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3.jpg\" alt=\"\" width=\"400\" height=\"202\" srcset=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3.jpg 400w, http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3-300x152.jpg 300w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><br \/>\n<strong><em>Fig. 74.4. \u2013 30 month FU showing the 2 patent branches. Dr. Antonios Polydorou, Cardiologist, Evangelismos Hospital Athens. Greece.<\/em><\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-22657\" src=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3-300x152.jpg\" alt=\"\" width=\"300\" height=\"152\" srcset=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3-300x152.jpg 300w, http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-3.jpg 400w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-22658\" src=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-4-300x163.jpg\" alt=\"\" width=\"300\" height=\"163\" srcset=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-4-300x163.jpg 300w, http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/multilayer-flow-modulator-for-treatment-of-taaas-4.jpg 450w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><br \/>\n<strong><em>Fig. 74.5. \u2013 SM aneurysm treated with Cardiatis multilayer flow modulator, post implant and FU at 1Y. Dr. Sameer Dani, Cardiologist, Life care Institute of Medical Science &amp; Research, Ahmedabad, India.<\/em><\/strong><\/p>\n<ul>\n<li>04. Patel HJ, Upchurch GR Jr, Eliason JL, Criado E, Rectenwald J, Williams DM, Deeb GM. Hybrid debranching with endovascular repair for thoracoabdominal aneurysms: a comparison with open repair. Ann Thorac Surg 2010;89(5):1475-81.<\/li>\n<li>05. Ferrero E, Ferri M, Viazzo A, Gaggiano A, Maggio D, Berardi G, Piazza S, Cumbo P, Pecchio A, Lamorgese V. Hybrid open and endovascular repair of recurrent visceral aortic patch aneurysmal expansion after previous thoracoabdominal aortic aneurysm repair: case report and description of technique. Minerva Chir 2010;65(3):393-400.<\/li>\n<li>06. Biasi L, Ali T, Loosemore T, Morgan R, Loftus I, Thompson M. Hybrid repair of complex thoracoabdominal aortic aneurysms using applied endovascular strategies combined with visceral and renal revascularization. J Thorac Cardiovasc Surg 2009;138(6):1331-8.<\/li>\n<li>07. Kieffer E, Chiche L, Godet G, Koskas F, Bahnini A, Bertrand M, Fl\u00e9ron MH, Goarin JP, Warnier de Wailly G, Benhamou AC. Type IV thoracoabdominal aneurysm repair: predictors of postoperative mortality, spinal cord injury, and acute intestinal ischemia. Ann Vasc Surg 2008;22(6): 822-8.<\/li>\n<li>08. Chocron S, Vaislic C, Bonneville JF. Multilayer stents in the treatment of chronic type B dissection. Annals of thoracic surgery, in press.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>C. VAISLIC, A. BENJELLOUN, J.-N. FABIANI, J.-F. BONNEVILLE, S. CHOCRON Abstract Current treatment of thoracoabdominal aneurysms is associated with significant morbidity and mortality. The most feared and devastating complication is paraplegia accompanied by sphincter and posture problems. To try and reduce these complications we have treated patients with multilayer flow modulators which preserve collateral circulation [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":23013,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[],"class_list":["post-23022","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-latest-publications"],"blocksy_meta":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Multilayer flow modulator for the treatment of TAAAs - Dr Claude Vaislic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Multilayer flow modulator for the treatment of TAAAs - Dr Claude Vaislic\" \/>\n<meta property=\"og:description\" content=\"C. VAISLIC, A. BENJELLOUN, J.-N. FABIANI, J.-F. BONNEVILLE, S. CHOCRON Abstract Current treatment of thoracoabdominal aneurysms is associated with significant morbidity and mortality. The most feared and devastating complication is paraplegia accompanied by sphincter and posture problems. To try and reduce these complications we have treated patients with multilayer flow modulators which preserve collateral circulation [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\" \/>\n<meta property=\"og:site_name\" content=\"Dr Claude Vaislic\" \/>\n<meta property=\"article:published_time\" content=\"2021-03-25T16:09:50+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-04-28T11:31:07+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/Featured-latest-publications.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"900\" \/>\n\t<meta property=\"og:image:height\" content=\"600\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Dr Claude Vaislic\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dr Claude Vaislic\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/#article\",\"isPartOf\":{\"@id\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\"},\"author\":{\"name\":\"Dr Claude Vaislic\",\"@id\":\"http:\/\/drclaudevaislic.com\/#\/schema\/person\/1ed27d6ab7f12cb495dd03d06cb7e6e6\"},\"headline\":\"Multilayer flow modulator for the treatment of TAAAs\",\"datePublished\":\"2021-03-25T16:09:50+00:00\",\"dateModified\":\"2021-04-28T11:31:07+00:00\",\"mainEntityOfPage\":{\"@id\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\"},\"wordCount\":677,\"publisher\":{\"@id\":\"http:\/\/drclaudevaislic.com\/#organization\"},\"image\":{\"@id\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/Featured-latest-publications.jpg\",\"articleSection\":[\"Latest Publications\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\",\"url\":\"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/\",\"name\":\"Multilayer flow modulator for the treatment of TAAAs - 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VAISLIC, A. BENJELLOUN, J.-N. FABIANI, J.-F. BONNEVILLE, S. CHOCRON Abstract Current treatment of thoracoabdominal aneurysms is associated with significant morbidity and mortality. The most feared and devastating complication is paraplegia accompanied by sphincter and posture problems. To try and reduce these complications we have treated patients with multilayer flow modulators which preserve collateral circulation [&hellip;]","og_url":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/","og_site_name":"Dr Claude Vaislic","article_published_time":"2021-03-25T16:09:50+00:00","article_modified_time":"2021-04-28T11:31:07+00:00","og_image":[{"width":900,"height":600,"url":"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/Featured-latest-publications.jpg","type":"image\/jpeg"}],"author":"Dr Claude Vaislic","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Dr Claude Vaislic","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/#article","isPartOf":{"@id":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/"},"author":{"name":"Dr Claude Vaislic","@id":"http:\/\/drclaudevaislic.com\/#\/schema\/person\/1ed27d6ab7f12cb495dd03d06cb7e6e6"},"headline":"Multilayer flow modulator for the treatment of TAAAs","datePublished":"2021-03-25T16:09:50+00:00","dateModified":"2021-04-28T11:31:07+00:00","mainEntityOfPage":{"@id":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/"},"wordCount":677,"publisher":{"@id":"http:\/\/drclaudevaislic.com\/#organization"},"image":{"@id":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/#primaryimage"},"thumbnailUrl":"http:\/\/drclaudevaislic.com\/wp-content\/uploads\/2021\/03\/Featured-latest-publications.jpg","articleSection":["Latest Publications"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/","url":"http:\/\/drclaudevaislic.com\/en\/multilayer-flow-modulator-for-the-treatment-of-taaas\/","name":"Multilayer flow modulator for the treatment of TAAAs - 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