Kinetic Elephant Trunk Technique: Early Results in Chronic Symptomatic Aortic Dissection Management

Commentary: When Promising Innovators Lack Strategic Vision: The Concept of Flow Modulation in Aortic Dissection

“…The decrease in the stented length of the aorta reduces the cardiovascular hemodynamic consequences. 9,11…”

“…The MFM is not a resolution for patients living on borrowed time and must not be used erratically in those patients in whom other modus operandi of aortic repair are not achievable. 10–14…”

“…7,9,10 Endovascular septotomy for chronic type B AD creates a single aortic channel. In the "kinetic elephant trunk" (KET) technique, 11 MFMs are deployed in the newly created single channel to stabilize the whole aorta. The KET improves flow into the hypoperfused visceral branches and equalizes the pressure between the false and true lumens.…”

“…The decrease in the stented length of the aorta reduces the cardiovascular hemodynamic consequences. 9,11 The retrospective single-center report of 23 cases presented by Costache et al 1 addresses the use of the MFM device in AD and adds to the existing data available, providing further information for physicians who need to be aware of MFM performance. However, no matter how informative this low-volume case series is, there is no escaping the controversy surrounding flow modulation technology in aortic pathology.…”

“…The MFM is not a resolution for patients living on borrowed time and must not be used erratically in those patients in whom other modus operandi of aortic repair are not achievable. [10][11][12][13][14] Costache et al 1 mirrored the findings of the MFM Global Registry that aortic aneurysms are chronic end-stage diseases in which the MFM cannot induce aortic remodeling once the TAAA diameter exceeds 6.2 cm. However, it does lower the aortic wall stress pressure, and that is why the MFM is suitable only for managing AD.…”