How Does the Multilayer Flow Modulator Work? The Science behind the Technical Innovation

Powell JT Gotensparre SM Sweeting MJ . Rupture rates of small abdominal aortic aneurysms: a systematic review of the literature. Eur J Vasc Endovasc Surg. 2011;41:2–10.

Pape LA Tsai TT Isselbacher EM . Aortic diameter ≥5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2007;116:1120–1127.

Darling RC Messina CR Brewster DC . Autopsy study of unoperated abdominal aortic aneurysms. The case for early resection. Circulation. 1977;56:II161–II164.

Hall AJ Busse EF McCarville DJ . Aortic wall tension as a predictive factor for abdominal aortic aneurysm rupture: improving the selection of patients for abdominal aortic aneurysm repair. Ann Vasc Surg. 2000;14:152–157.

Knipp BS Deeb GM Prager RL . A contemporary analysis of outcomes for operative repair of type A aortic dissection in the United States. Surgery. 2007;142:524–528.

Simao da Silva E Rodrigues AJ Magalhaes Castro de Tolosa E . Morphology and diameter of infrarenal aortic aneurysms: a prospective autopsy study. Cardiovasc Surg. 2000;8:526–532.

Kontopodis N Metaxa E Papaharilaou Y . Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment. Eur J Radiol. 2014;83:1051–1056.

Chandra S Raut SS Jana A . Fluid-structure interaction modeling of abdominal aortic aneurysms: the impact of patient-specific inflow conditions and fluid/solid coupling. J Biomech Eng. 2013;135:81001.

Gasser TC Nchimi A Swedenborg J . A novel strategy to translate the biomechanical rupture risk of abdominal aortic aneurysms to their equivalent diameter risk: method and retrospective validation. Eur J Vasc Endovasc Surg. 2014;47:288–295.

Doyle BJ Hoskins PR McGloughlin TM . Computational rupture prediction of AAAs: what needs to be done next? J Endovasc Ther. 2011;18:226–229.

Fillinger MF Raghavan ML Marra SP . In vivo analysis of mechanical wall stress and abdominal aortic aneurysm rupture risk. J Vasc Surg. 2002;36:589–597.

Fillinger MF Marra SP Raghavan ML . Prediction of rupture risk in abdominal aortic aneurysm during observation: wall stress versus diameter. J Vasc Surg. 2003;37:724–732.

Raghavan ML Vorp DA Federle MP . Wall stress distribution on three-dimensionally reconstructed models of human abdominal aortic aneurysm. J Vasc Surg. 2000;31:760–769.

Truijers M Pol JA SchultzeKool LJ . Wall stress analysis in small asymptomatic, symptomatic and ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2007;33:401–407.

Venkatasubramaniam AK Fagan MJ Mehta T . A comparative study of aortic wall stress using finite element analysis for ruptured and non-ruptured abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2004;28:168–176.

Elger DF Blackketter DM Budwig RS . The influence of shape on the stresses in model abdominal aortic aneurysms. J Biomech Eng. 1996;118:326–332.

Sacks MS Vorp DA Raghavan ML . In vivo three dimensional surface geometry of abdominal aortic aneurysms. Ann Biomed Eng. 1999;27:469–479.

Doyle BJ Callanan A Burke PE . Vessel asymmetry as an additional diagnostic tool in the assessment of abdominal aortic aneurysms. J Vasc Surg. 2009;49:443–454.

Wang DH Makaroun MS Webster MW . Effect of intraluminal thrombus on wall stress in patient-specific models of abdominal aortic aneurysm. J Vasc Surg. 2002;36:598–604.

Vande Geest JP Wang DH Wisniewski SR . Towards a noninvasive method for determination of patient-specific wall strength distribution in abdominal aortic aneurysms. Ann Biomed Eng. 2006;34:1098–1106.

Vorp DA Lee PC Wang DH . Association of intraluminal thrombus in abdominal aortic aneurysm with local hypoxia and wall weakening. J Vasc Surg. 2001;34:291–299.

Duprey A Khanafer K Schlicht M . In vitro characterisation of physiological and maximum elastic modulus of ascending thoracic aortic aneurysms using uniaxial tensile testing. Eur J Vasc Endovasc Surg. 2010;39:700–707.

Brown PM Zelt DT Sobolev B . The risk of rupture in untreated aneurysms: the impact of size, gender, and expansion rate. J Vasc Surg. 2003;37:280–284.

Hatakeyama T Shigematsu H Muto T . Risk factors for rupture of abdominal aortic aneurysm based on three-dimensional study. J Vasc Surg. 2001;33:453–461.

Sonesson B Sandgren T Lanne T . Abdominal aortic aneurysm wall mechanics and their relation to risk of rupture. Eur J Vasc Endovasc Surg. 1999;18:487–493.

Stenbaek J Kalin B Swedenborg J . Growth of thrombus may be a better predictor of rupture than diameter in patients with abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2000;20:466–469.

Campa JS Greenhalgh RM Powel JT . Elastin degradation in abdominal aortic aneurysms. Atherosclerosis. 1987;65:13–21.

Menashi S Campa JS Greenhalgh RM . Collagen in abdominal aortic aneurysm: typing, content and degradation. J Vasc Surg. 1987;6:578–582.

Reilly JM . Plasminogen activors in abdominal aortic aneurysmal disease. Ann N Y Acad Sci. 1996;800:151–156.

Rizzo RJ McCarthy WJ Dixit SN . Collagen types and matrix protein content in human abdominal aortic aneurysms. J Vasc Surg. 1989;10:365–373.

Ruddy JM Jones JA Spinale FG . Regional heterogeneity within the aorta: relevance to aneurysm disease. J Thorac Cardiovasc Surg. 2008;136:1123–1130.

Sakalihasan N Heyeres A Nusgens BV Modifications of the extracellular matrix of aneurysmal abdominal aortas as a function of their size. Eur J Vasc Surg. 1993;7:633–637.

Sakalihasan N Delvenne P Nusgens BV . Activated forms of MMP2 and MMP9 in abdominal aortic aneurysms. J Vasc Surg. 1996;24:127–133.

Reeps C Essler M Pelisek J . Increased 18F-fluorodeoxyglucose uptake in abdominal aortic aneurysms in positron emission/computed tomography is associated with inflammation, aortic wall instability, and acute symptoms. J Vasc Surg. 2008;48:417–423.

Vollmar JF Pauschinger P Paes E . Aortic aneurysms as a late sequelae of above-knee amputation. Lancet. 1989;2:834–835.

Xenos M Rambhia SH Alemu Y . Patient-based abdominal aortic aneurysm risk prediction with fluid structure interaction modeling. Ann Biomed Eng. 2010;38:3323–3337.

Gasser TC Auer M Labruto F . Biomechanical rupture risk assessment of abdominal aortic aneurysms: model complexity versus predictability of finite element simulations. Eur J Vasc Endovasc Surg. 2010;40:176–185.

Ku DN Giddens DP Zarins CK . Pulsatile flow and atherosclerosis in the human carotid bifurcation: positive correlation between plaque location and low oscillating shear stress. Arteriosclerosis. 1985;5:293–302.

Chen XL Varner SE Rao AS . Laminar shear stress induction of antioxidant response element-mediated genes in endothelial cells: a novel anti-inflammatory mechanism. J Biol Chem. 2003;278:703–711.

White JV Haas K Phillips S . Adventitial elastolysis is a primary event in aneurysm formation. J Vasc Surg. 1993;17:371–380.

Vorp DA Raghavan ML Muluk SC . Wall strength and stiffness of aneurysmal and nonaneurysmal abdominal aorta. Ann N Y Acad Sci. 1996;800:274–276.

Maier A Gee MW Reeps C . A comparison of diameter, wall stress, and rupture potential index for abdominal aortic aneurysm rupture risk prediction. Ann Biomed Eng. 2010;38:3124–3134.

Molony DS Kavanagh EG Walsh MT . A computational study of the magnitude and direction of migration forces in patient-specific abdominal aortic aneurysm stent-grafts. Eur J Vasc Endovasc Surg. 2010;40:332–339.

Sampaio SM Panneton JM Mozes G . Aortic neck dilation after endovascular abdominal aortic aneurysm repair: Should oversizing be blamed? Ann Vasc Surg. 2006;20:338–345.

Sultan S Sultan M Hynes N . Early mid-term results of the first 103 cases of multilayer flow modulator stent done under indication for use in the management of thoracoabdominal aortic pathology from the independent global MFM registry. J Cardiovasc Surg (Torino). 2014;55:21–32.

Sultan S Hynes N Tawfick W . Disruptive endovascular technology with multilayer flow modulator stents (MFM) as a therapeutic option in the management of thoracoabdominal aortic aneurysms: early results from the global independent MFM registry. Ital J Vasc Endovasc Surg. 2012;19:215–228.

Vorp DA Raghavan ML Webster MW . Mechanical wall stress in abdominal aortic aneurysm: influence of diameter and asymmetry. J Vasc Surg. 1998;27:632–639.

Vallabhaneni SR Gilling-Smith GL How TV . Heterogeneity of tensile strength and matrix metalloproteinase activity in the wall of abdominal aortic aneurysms. J Endovasc Ther. 2004;11:494–502.

Kadoglou NP Moulakakis KG Papadakis I . Changes in aortic pulse wave velocity of patients undergoing endovascular repair of abdominal aortic aneurysms. J Endovasc Ther. 2012;19:661–666.

Yamazumi K Ojiro M Okumura H . An activated state of blood coagulation and fibrinolysis in patients with abdominal aortic aneurysm. Am J Surg. 1998;175:297–301.

Lindholt JS Heegaard NH Vammen S . Smoking, but not lipids, lipoprotein(a) and antibodies against oxidised LDL, is correlated to the expansion of abdominal aortic aneurysms. Eur J Vasc Endovasc Surg. 2001;21:51–56.

Golledge J Iyer V Jenkins J . Thrombus volume is similar in patients with ruptured and intact abdominal aortic aneurysms. J Vasc Surg. 2014;59:315–320.

Li ZY U-King-Im J Tang TY . Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm. J Vasc Surg. 2008;47:928–935.

Inzoli F Boschetti F Zappa M . Biomechanical factors in abdominal aortic aneurysm rupture. Eur J Vasc Surg. 1993;7:667–674.

Coen M Gabbiani G Bochaton-Piallat ML . Myofibroblast-mediated adventitial remodeling: an underestimated player in arterial pathology. Arterioscler Thromb Vasc Biol. 2011;31:2391–2396.

Sultan S Kavanagh E Hynes N . Endothelialization processes and kinetics of stents. Presented at the International Society for Vascular Surgery Annual Meeting held in Guangzhou, China, on July 10–12, 2014.

Lazaris AM Maheras AN Vasdekis SN . A multilayer stent in the aorta may not seal the aneurysm, thereby leading to rupture. J Vasc Surg. 2012;56:829–831.