The in-hospital costs of treating high-risk patients with fenestrated and branched endografts

Osman, Elrasheed; Tan, Kong Teng; Tse, Leonard W.; Jaskolka, Jeffrey D.; Roche-Nagle, Graham; Oreopoulos, George; Rubin, Barry B.; Lindsay, Thomas F.

doi:10.1016/j.jvs.2015.07.040

Cited by 21 publications

(13 citation statements)

References 40 publications

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“…However, it does lower the aortic wall stress pressure, and that is why the MFM is suitable only for managing AD. [15][16][17][18][19][20][21][22][23][24] The MFM Global Registry concurs with Costache et al 1 that TAAA was the main indication for MFM stents when they were first introduced to the market, and they had promising short-term results. However, these did not hold true in the long term, and physicians are currently avoiding the implantation of MFM for TAAA, with some evidence suggesting that the device does not alter the natural history of progression to rupture.…”

supporting

confidence: 60%

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

2020

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supporting

confidence: 60%

“…However, it does lower the aortic wall stress pressure, and that is why the MFM is suitable only for managing AD. 15–24…”

mentioning

confidence: 99%

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

2020

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“…11,12 Furthermore, long-term follow-up is lacking, and fenestrated/branched endovascular repair is limited by the high treatment costs and the need for time-consuming personalized device manufacturing, thereby excluding use in emergency situations. 13…”

Section: Introductionmentioning

confidence: 99%

One-Year Single-Center Results of the Multilayer Flow Modulator Stents for the Treatment of Type B Aortic Dissection

et al. 2020

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Purpose To report a single-center series of patients with type B aortic dissection treated with the Multilayer Flow Modulator (MFM). Materials and Methods Over a 36-month period, 23 patients (median age 53 years; 20 men) with complicated type B aortic dissections (2 acute, 5 subacute, and 16 chronic) were treated with the MFM. Primary endpoints of rupture or dissection-related death, overall mortality, and reintervention were evaluated using the Kaplan-Meier method; estimates for freedom from the endpoints are reported with the 95% confidence interval (CI). Secondary outcomes included technical success, adverse events, and aortic remodeling. Clinical and imaging data were collected preoperatively, directly postoperatively, and annually to 36 months for analysis using computational fluid dynamics (CFD). Results Initial technical success was 91.3%. The estimates of the endpoints at 12 months were 100% for freedom from rupture or aortic-related death, 95.7% for freedom from overall mortality, and 91.3% for freedom from reintervention. No device-related neurological or systemic complications occurred, and no additional reinterventions were needed during follow-up. A total of 144 branches overstented by the MFM remained patent. Morphologic analysis of the aortic dissection showed progressive true lumen volume increase (75.9%, p<0.001) with concomitant false lumen volume decrease (42.8%, p<0.001); the CFD analyses showed increased laminar flow. Conclusion In the current series, the MFM provided a safe and feasible treatment option for complicated acute, subacute, and chronic type B aortic dissections, with high technical success, low mortality, and active aortic remodeling. Further studies should elucidate the long-term safety of the MFM and its effectiveness in a larger patient cohort.

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“…16–18 Fenestrated or branched EVAR procedures entail greater risks for serious complications and attendant hospital costs. 19–20 More research is needed to define cost-effectiveness as a function of procedural complexity, particularly for high-volume centers for whom these patients are usually referred.…”

Section: Discussionmentioning

confidence: 99%

Episode-based cost reduction for endovascular aneurysm repair

Itoga

Patterson

Ohkuma

et al. 2019

Journal of Vascular Surgery

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The in-hospital costs of treating high-risk patients with fenestrated and branched endografts

Abstract: bEVAR and fEVAR are expensive interventions. Intraoperative adverse events and postoperative systemic complications dramatically increase costs and length of stay. Measures to minimize complications will reduce hospitalization costs and improve patient outcomes.

Cited by 21 publications

References 40 publications

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

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

One-Year Single-Center Results of the Multilayer Flow Modulator Stents for the Treatment of Type B Aortic Dissection

Episode-based cost reduction for endovascular aneurysm repair

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