Multilayer Flow Modulator Stent for Aortic Pathology: A Meta-Analysis and Additional Data from a Single-Centre...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Thoracoabdominal aneurysms and aortic dissections present significant challenges in vascular surgery.
• Comorbidities and anatomical restrictions limit treatment options like open surgery or endografts.
• The multilayer flow modulator (MFM) presents a potential alternative for select high-risk patients.

Purpose of the Study:

• To systematically review and describe the clinical experience with the multilayer stent (MFM).
• To augment existing data by including a cohort of patients treated with MFM at the authors' hospital.
• To evaluate the safety and efficacy of MFM in complex aortic pathologies.

Main Methods:

• A systematic review adhering to PRISMA guidelines was conducted.
• Data from consecutive patients treated with MFM for type B dissections and thoracoabdominal/thoracic aneurysms (May 2013-August 2020) were retrieved.
• Single-arm meta-analyses were performed using OpenMeta, including 12 studies and a local hospital cohort.

Main Results:

• Technical success rates were high (97.3% hospital cohort, 97.8% meta-analysis).
• 30-day mortality was 5.4% in the hospital cohort; off-label implantation correlated with higher aneurysm-related mortality.
• Persistent perfusion occurred in 68.5% of meta-analysis patients; 1-year rupture risk was 2.1%.

Conclusions:

• The quality of evidence is limited by poor long-term data and non-comparative studies.
• MFM implantation shows a low incidence of perioperative complications but a high rate of persistent perfusion.
• Further research is needed to understand the long-term outcomes and optimize MFM use.