Streamliner Multilayer Flow Modulator stents as a therapeutic option in the management of complex thoraco-abdominal aortic pathology report from Global SMFM Registry

Complex thoraco-abdominal aortic aneurysm (TAAA) patients remain a challenge irrespective of treatment choice. The Streamliner Multilayer Flow Modulator (SMFM) is an alternative modality of treatment and it is conceptually at variance with conventional treatment modes.Preliminary results show that treatment of infra-renal AAA, juxta-renal AAA, Stanford Type B dissection and Crawford Type V by the SMFM device were most successful. Large volumes of more than 450 cm3 in pathologies such as Crawford Type II and Type IV, should be labelled as a contraindication for use of the SMFM. C-reactive protein, haemoglobin, aneurysm volume and maximum diameter all play major roles in successful treatment. The greater the length of the aorta to be covered and the greater the number of stents utilized, the greater the risk of adverse events and mortality. Patient requiring a reintervention with an additional SMFM(s) within 200 days of primary treatment increases mortality. Both length of the pathology and rate of reintervention indicate a severe aortic pathology burden and its aggressive nature.The SMFM harnesses the body's innate physiological processes to modulate the aneurysm, with no risk of critical shuttering or loss of native side branches. The SMFM offers less operative trauma, shorter procedure times and reduced hospital stays. It offers simplicity, consistency and reproducibility in one treatment. However, the SMFM is not a solution for patients living on borrowed time. It is a promising disruptive technology, only in safe hands and must be utilized under strict instructions for use.