A Systematic Review and Metanalysis of the Multilayer Flow Modulator in the Management of Complex Thoracoabdominal Aortic Pathology
Sherif Sultan, MD FRCS FACS, Ala ElHelali, Edel P. Kavanagh, Niamh Hynes.
Western Vascular Institute, Galway, Ireland.
OBJECTIVES: The aim of this review is to consider evidence for the Multilayer Flow Modulator (MFM) device in management patients with complex thoracoabdominal aortic aneurysm (TAAA) or dissection.
METHODS: A methodical search of all health databases was conducted from January 2008 to 2015 for health related and biomedical science literature, pertaining to the MFM. Primary outcome was aneurysm-related survival. Secondary outcomes were all-cause survival, stroke, spinal cord ischemia, renal impairment and branch vessel patency
RESULTS: A total of 15 studies (3 prospective studies, 3 observational reviews and 9 case reports) were included. The mean age of patients was 68.85years (+/-12.34 years), mean aneurysm diameter was 6.67cm (±1.57cm). Technical success reported in 15 studies was 77.2 %. Aneurysm related survival at one year was 78.7% (±3.92%). One year all-cause survival was 53.7 % (±3.94%). There were no reported cases of spinal cord ischemia or renal insult.
CONCLUSIONS: The MFM appears safe in management of TAAA, once operators abide to its Indications for Use. Since the MFM is a new technology, there is paucity of long-term follow-up data, a lack of comparative studies and a requirement for randomized clinical trials and continued assessment.
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