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

[...]aneurysms with diameters more than double the cutoff value remain intact prior to elective repair, while on the other hand, up to 23% of aortic aneurysms have been reported to rupture at diameters below 5 cm.1-6 These inconsistencies lead one to believe that a 2-dimensional (2D) marker such as...

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Bibliographic Details
Published in:Journal of endovascular therapy 2014-12, Vol.21 (6), p.814-821
Main Authors: Sultan, Sherif, Hynes, Niamh, Kavanagh, Edel P., Diethrich, Edward B.
Format: Article
Language:English
Subjects:
Abdomen
Aneurysms
Aorta, Abdominal - physiopathology
Aorta, Abdominal - surgery
Aortic Aneurysm, Abdominal - diagnosis
Aortic Aneurysm, Abdominal - physiopathology
Aortic Aneurysm, Abdominal - surgery
Aortic Rupture - diagnosis
Aortic Rupture - physiopathology
Aortic Rupture - surgery
Biomechanical Phenomena
Biomechanics
Blood clots
Blood Flow Velocity
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - instrumentation
Computer-Aided Design
Diffusion of Innovation
Einstein, Albert (1879-1955)
Endothelium
Geometry
Humans
Models, Cardiovascular
Prosthesis Design
Regional Blood Flow
Shear stress
Smooth muscle
Stress, Mechanical
Treatment Outcome
Vortices
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Summary:[...]aneurysms with diameters more than double the cutoff value remain intact prior to elective repair, while on the other hand, up to 23% of aortic aneurysms have been reported to rupture at diameters below 5 cm.1-6 These inconsistencies lead one to believe that a 2-dimensional (2D) marker such as diameter may be too basic a measure and really only of historic relevance. [...]the rupture potential is highest where the ratio of peak wall stress to peak wall strength is higher. [...]the maximum diameter criterion to predict rupture risk ignores the important roles of vessel wall topography, geometry, wall stiffness, intraluminal thrombus thickness, calcification, iliac bifurcation angle, rate of aneurysm growth, and peak wall WHY ANEURYSMS EXPAND AND RUPTURE The pathophysiology of aneurysmal disease is characterized by thinning of the aortic media resulting from proteolytic injury to the extracellular matrix and to smooth muscle cell senescence and apoptosis, allowing further proteolytic injury leading to dilation and rupture.27-33 Aneurysms of the aortic root and ascending aorta are most commonly related to cystic medial degeneration.
ISSN:1526-6028
1545-1550
DOI:10.1583/14-4858.1