초록접수 현황
| 20F-200 | 구연 발표 |
Case: 2 Year Follow up of Multilayer flow modulator (MFM) for distal stent graft-induced new entry (SINE) after Hybrid thoracic endovascular aortic repair (TEVAR) in complicated type B dissection (Type B AD)
Joon Hyuk Kong
Department of thoracic and cardiovascular surgery, Mediplex Sejong General Hospital
Purpose : Stent graft-induce new entry after the thoracic endovascular aortic repair is a condition that then leads to death, it requires immediate treatment. Multilayer flow modulator as endovascular repair aortic dissections can be performed with promising results in high-risk patients with complex disease anatomy.
Methods : A 62-year-old male underwent one-staged hybrid operation with thoracic endovascular aortic repair (TEVAR). Three years later, computed tomography angiography showed a stable arch, and the distal stent graft-induced new entry tear (SINE). The patient's comorbidities (severe chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, prior hybrid operation, and hypertension) made even more high risk an already technically complex surgical operation to replace the descending thoracic aorta and abdominal aorta. We decided to proceed with an endovascular procedure with a multilayer flow modulator (MFM). The 1st
MFM landed 5 cm distally at the level of the superior mesenteric artery (SMA) and 2nd and 3rd MFM landed proximally at the middle level of the previous TEVAR stent-graft. All branches were perfused and patent.
Results : After an uneventful 3-month, a follow-up CT scan showed a thrombosed aneurysmal sac with patent branch vessels. During 2 year follow up period, there was no issue.
Conclusion : The mode of action of MFM forces us to completely rethink aneurysm pathogenesis and, consequently, it has been met with much cynicism. We aim to uncloak some of the mystery surrounding the MFM, clarify its mode of action, and explore the truth behind its clinical effectiveness.
Methods : A 62-year-old male underwent one-staged hybrid operation with thoracic endovascular aortic repair (TEVAR). Three years later, computed tomography angiography showed a stable arch, and the distal stent graft-induced new entry tear (SINE). The patient's comorbidities (severe chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, prior hybrid operation, and hypertension) made even more high risk an already technically complex surgical operation to replace the descending thoracic aorta and abdominal aorta. We decided to proceed with an endovascular procedure with a multilayer flow modulator (MFM). The 1st
MFM landed 5 cm distally at the level of the superior mesenteric artery (SMA) and 2nd and 3rd MFM landed proximally at the middle level of the previous TEVAR stent-graft. All branches were perfused and patent.
Results : After an uneventful 3-month, a follow-up CT scan showed a thrombosed aneurysmal sac with patent branch vessels. During 2 year follow up period, there was no issue.
Conclusion : The mode of action of MFM forces us to completely rethink aneurysm pathogenesis and, consequently, it has been met with much cynicism. We aim to uncloak some of the mystery surrounding the MFM, clarify its mode of action, and explore the truth behind its clinical effectiveness.
책임저자: Joon Hyuk Kong
Department of thoracic and cardiovascular surgery, Mediplex Sejong General Hospital
발표자: Joon Hyuk Kong, E-mail : joonhyukkong@empas.com