Jekyll2022-12-06T11:12:18+00:00http://badaorta.com/Now Available. AORTA Merchandise2022-12-04T08:00:00+00:002022-12-04T08:00:00+00:00http://badaorta.com/now-available-aorta-merchandise<p>BadAorta is pleased to make available an exciting line of AORTA merchandise.</p>
<p>Now is your chance to let everyone know about your passion for the AORTA.<img src="/uploads/image-6487327-2.JPG" alt="" width="2732" height="1873" /></p>
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<p> </p>
<div class="cta-box">
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<p>Now Available. Get your AORTA Merchandise at our store.</p>
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</div>BadAorta: A Deep Dive Into Aortic Disease, It’s Treatment And The Latest Research: Volume One: Aortic Dissections2022-09-08T00:00:00+00:002022-09-08T00:00:00+00:00http://badaorta.com/badaorta-volume-one-aortic-dissections<h3> </h3>
<blockquote>
<p>From an experienced Heart Surgeon and author of <a href="https://amzn.to/3RPaf8u" target="_blank" rel="noopener">Risk Factors For Developing Aortic Disease: A Tool For Patients and Physicians </a>comes a breakthrough book that pulls back the curtains like never before on one of the most challenging heart problems known to Medicine – Aortic Dissections.</p>
</blockquote>
<h4 id="the-art-and-science-of-aortic-disease"><strong>The art and science of aortic disease.</strong></h4>
<p><a href="https://amzn.to/3Bjswob" target="_blank" rel="noopener"><img src="/uploads/a--bad-aorta.jpg" alt="BadAorta: A Deep Dive Into Aortic Disease, It's Treatment And The Latest Research: Volume One: Aortic Dissections" title="BadAorta: A Deep Dive Into Aortic Disease, It's Treatment And The Latest Research: Volume One: Aortic Dissections" width="1940" height="2540" /></a></p>
<p>Many years ago, I experienced an “aha” moment.</p>
<p>After over a decade of taking care of patients, I had an epiphany that a “voice” was missing from the conversations that patients and surgeons were having daily about the difficult choices involved with managing complex diseases of the aorta.</p>
<p>The missing voice was clear, concise, and easy-to-understand information about the anatomy of the aorta, the different types of aortic problems that develop, and the available treatment options. It is not a poor reflection of patients’ ability to understand the information, nor is it a judgment on how surgeons discuss aortic problems with their patients.</p>
<p>Instead, my insight into how to bridge the communication gap between patient and surgeon regarding managing complex aortic diseases is an honest recognition of the “nature of the beast.”</p>
<p>My mission from that point forward was to assist patients with understanding the complexities of aortic disease so that they could make more informed (and better) decisions about their treatment decisions.</p>
<p>As a result, I started <a href="https://amzn.to/3p16Gjj" target="_blank" rel="noreferrer noopener">badaorta.com</a> as a place where I could discuss topics that patients with aortic disease frequently encounter. However, it has evolved into a more extensive library and discussion of information related to the aorta.</p>
<p>This book updates and expands on a few of the “Top 10” blog posts from my website.</p>
<p>Several new chapters have been added covering topics not addressed on my website.</p>
<p>This book represents a step forward.</p>
<p>First, it expands upon the information I generated several years ago to help patients.</p>
<p>Second, it is the first volume of books covering important information and research regarding the aorta.</p>
<ul>
<li>
<h5 id="learn-the-differences-between-an-acute-aortic-dissection-and-a-chronic-aortic-dissection"><strong>Learn the differences between an acute aortic dissection and a chronic aortic dissection</strong></h5>
</li>
<li>
<h5 id="find-out-if-the-month-of-the-year-affects-your-chances-of-surviving-an-aortic-dissection"><strong>Find out if the month of the year affects your chances of surviving an aortic dissection</strong></h5>
</li>
</ul>
<p>The field of aortic disease and aortic treatments is exploding with new information about the processes that contribute to the development of aortic disease and new breakthroughs in less-invasive treatments.</p>
<p>Stay abreast of the rapidly changing field of aortic disease and gain invaluable insights about aortic dissections from an expert.</p>
<h4 id="buy-now-at-amazon"><a href="https://amzn.to/3SbdAiv" target="_blank" rel="noopener">BUY NOW at Amazon</a></h4>A breakthrough book that pulls back the curtains like never before on one of the most challenging heart problems known to Medicine – Aortic Dissections.Risk Factors For Developing Aortic Disease (Second Edition): A Tool For Patients and Physicians2022-08-29T00:00:00+00:002022-08-29T00:00:00+00:00http://badaorta.com/risk-factors-for-developing-aortic-disease-second-edition<p> </p>
<p> </p>
<blockquote>
<p><em>Aortic disease is called a silent killer because often there are no symptoms prior to an aortic emergency. Knowing the risk factors for developing aortic disease can save your life.</em></p>
</blockquote>
<p> </p>
<h4 id="we-live-in-an-era-of-personalized-medicine">We live in an era of personalized medicine.</h4>
<p> </p>
<p><a href="https://amzn.to/3BY2xUR" target="_blank" rel="noopener"><img src="/uploads/a--risk-factors-1.jpg" alt="Risk Factors For Developing Aortic Disease (Second Edition): A Tool For Patients and Physicians Dr. Grayson Wheatley" title="Risk Factors For Developing Aortic Disease (Second Edition): A Tool For Patients and Physicians" width="1940" height="2540" /></a></p>
<p>Too few individuals know their personal risk for developing a problem with their aorta.</p>
<p> </p>
<p>In Healthcare, we call this aortic risk-stratification.</p>
<p> </p>
<p>Many factors impact whether someone develops an aortic aneurysm or an aortic dissection. Some risk factors are within your control, while others are not.</p>
<p> </p>
<p>The first step to preventing a life-threatening aortic catastrophe is to know all of the risk factors which apply to you. Once you know these factors, it is a shared decision between you and your physician on whether it makes sense to get screened for an aortic aneurysm.</p>
<p> </p>
<p>Aortic disease is a significant health concern both in the US and globally.</p>
<p> </p>
<p>Aortic disease is the 19th leading cause of death in the United States. Other countries have similar rates of death from aortic disease.</p>
<p> </p>
<p>Like any other organ in the body, the aorta can fail emergently and quickly become a life-threatening problem, such as an aortic dissection or an aortic aneurysm.</p>
<p> </p>
<p>Your aorta is the superhighway connecting your heart to the rest of your body.</p>
<p> </p>
<p>While the heart is the engine that tirelessly pumps oxygen-rich blood to every part of the body, the aorta is the conduit that enables the blood to reach and nourish every aspect of the body.</p>
<p> </p>
<p>This <a href="https://amzn.to/3dhpYPq" target="_blank" rel="noopener">all-new Second Edition</a> provides helpful information on what factors contribute to the development of aortic disease.</p>
<p> </p>
<p><strong>In this book, I discuss:</strong></p>
<ul>
<li><strong>Inherited Risk Factors</strong></li>
<li><strong>Environmental Risk Factors</strong></li>
<li><strong>Demographic Risk Factors</strong></li>
<li><strong>Next Steps</strong></li>
</ul>
<p> </p>
<p>One of this book’s important take-home messages is that more people need to understand their personal risk for developing aortic disease. Individuals at increased risk may need to undergo testing to get screened for aortic disease.</p>
<p> </p>
<p>If you or someone you know has an aortic problem, it is crucial that you understand what causes aortic disease.</p>
<p> </p>
<p><strong>Take the next step. Know the risks.</strong></p>
<p> </p>
<h4 id="buy-now-at-amazon"><a href="https://amzn.to/3BY2xUR" target="_blank" rel="noopener">BUY NOW at Amazon</a></h4>Aortic disease is called a silent killer because often there are no warning signs prior to an aortic emergency. Knowing the risk factors for developing aortic disease can save your life.Family Ties: What Your Aorta Says About Your Family History2022-08-18T00:00:00+00:002022-08-18T00:00:00+00:00http://badaorta.com/family-ties-what-your-aorta-says-about-your-family-history<h3 id="your-aorta-can-tell-you-a-lot-about-your-family-history"><em>Your aorta can tell you a lot about your family history.</em></h3>
<blockquote>
<p>Give me 5 minutes with a patient and I can get a very good sense of how likely it is that they have a problem with their aorta. <a href="http://www.drgraysonwheatley.com/" target="_blank" rel="noopener ugc nofollow">Dr. Grayson Wheatley</a></p>
</blockquote>
<p><img src="/uploads/riskfactors-insta-1.png" alt="" width="1080" height="1080" />It’s true — you carry around your family history in your aorta.</p>
<p>Let’s start from the beginning. Your <a href="http://badaorta.com/aorticatlas/" target="_blank" rel="noopener ugc nofollow">aorta is the major blood vessel of the body</a>. It connects directly to the heart at the level of the aortic valve and receives all of the blood pumped from the left side of the heart.</p>
<p>From its origin at the level of the heart, the aorta “ascends” in the chest to the base of the neck and then “arches” around and then “descends” down the chest to run the length of the torso. The aorta is immediately adjacent to the spinal column.</p>
<p>The aorta is a large blood vessel — on average an inch or more in diameter — and gives off branches to all vital organs in the body (including the brain).</p>
<p>The aorta is an elastic structure that expands and contracts with every heartbeat.</p>
<p>In order to repeatedly expand and contract and remain durable, the integrity of the aorta must stay viable.</p>
<h1> </h1>
<h1 id="the-aorta-can-wear-out"><strong>The Aorta Can “Wear Out”</strong></h1>
<p>Aortic diseases develop because of a breakdown in the integrity of the elastic tissue within the wall of the aorta.</p>
<p>There are several ways that the elastic tissue in the aorta can “wear out”.</p>
<p>The natural process of aging and generalized weakening of all tissues in the body can affect the aorta, just like it affects the skin. I tell my patients: “Just like we develop wrinkles of the skin as we age, we can similarly develop imperfections of the aorta on the inside. The accumulation of imperfections of the aorta over many years due to aging can result in an <a href="http://badaorta.com/the-root-of-the-matter-disease-of-the-aortic-root/" target="_blank" rel="noopener ugc nofollow">aortic aneurysm</a> or <a href="http://badaorta.com/flirting-disaster-acute-aortic-dissections/" target="_blank" rel="noopener ugc nofollow">aortic dissection</a>.”</p>
<p>Other lifestyle factors can directly affect the aorta — which are very similar to the factors which impact the development of heart disease — which only exacerbate the natural degeneration associated with aging. Those factors are high blood pressure, high blood cholesterol, and tobacco smoking.</p>
<h1 id="-1"> </h1>
<h1 id="aortic-problems-can-run-in-families"><strong>Aortic Problems Can Run in Families</strong></h1>
<p>However, problems with the aorta can be inherited.</p>
<p>Yes, let me say that again: there are biological traits that you can inherit from your family which can directly result in the development of an aortic aneurysm or propensity for developing an aortic dissection.</p>
<p>This information is critical for everyone to understand.</p>
<p>If anyone in your family (immediate or remote) has ever been treated for an aortic problem, it is imperative that you have a check-up by a heart specialist to assess your risk of having an aortic problem.</p>
<p>There are some genetic markers that we can test for which relate to aortic disease, but we don’t recommend that testing unless there are physical features that are associated with common inherited connective tissue disorders such as Marfan Syndrome.</p>
<p>Most of the inherited conditions that predispose people to develop an aortic problem relate to disorders at the genetic level involving the elastic tissue within the wall of the aorta.</p>
<h1 id="-2"> </h1>
<h1 id="the-6-most-common-reasons-that-someone-dies-suddenly"><strong>The 6 Most Common Reasons that someone dies suddenly</strong></h1>
<p>If you have been told that someone in your family has “died suddenly”, there are usually a few common reasons.</p>
<ol>
<li>Heart attack — sudden loss of blood flow to the heart muscle from a blockage in a coronary artery.</li>
<li>Aortic dissection — a sudden, immediate ripping or tearing of the aorta.</li>
<li>Ruptured aortic aneurysm — a bursting of the aorta in an area that is weakened, resulting in massive internal bleeding.</li>
<li>Pulmonary embolus — a blood clot that develops in the veins of the legs and suddenly breaks off and travels to the heart and shuts off blood flow to the lungs.</li>
<li>Stroke — a blot clot or bleeding in the brain.</li>
<li>Cardiac arrhythmia — a sudden onset of an abnormal heart rhythm that impairs the ability of the heart to pump</li>
</ol>
<h1 id="-3"> </h1>
<h1 id="your-family-medical-history-is-important"><strong>Your family medical history is important</strong></h1>
<p><a href="http://badaorta.com/meet-cullen-timmons-diagnosing-his-own-aortic-aneurysm/" target="_blank" rel="noopener ugc nofollow">Knowing your family’s medical history could save your life.</a></p>
<p>If the cause of death of someone in your family history was diagnosed as resulting from an aortic problem, then you should get checked out for an aortic problem by a heart specialist. <a href="http://www.drgraysonwheatley.com/aorticcenter" target="_blank" rel="noopener ugc nofollow">Preferably someone with expertise in aortic diseases.</a></p>
<p>If someone in your family died suddenly from unknown causes, then you should also get checked out by a heart specialist for an aortic problem since one of the potential ways your ancestor may have died suddenly could have been from an aortic problem.</p>
<p>Bottom line: your aorta carries your genetic lineage within its walls and your life could depend on the type of aortic tissue you have in the wall of your aorta from birth.</p>
<p>Quite often if someone has an inherited aortic problem, they develop an aortic disease before the age of 55 years.</p>
<p>If you have a family history of aortic disease, even if your initial evaluation for aortic disease is negative, you should still get screened every 5 years for an aortic problem.</p>
<p>A special situation is for patients with a bicuspid aortic valve. These are people who are born with a structurally abnormal aortic heart valve. This inherited condition predisposes people to develop aneurysms of the ascending aorta at a young age. Screening is important in these patients as well.</p>
<h1 id="-4"> </h1>
<h1 id="pass-this-along-you-could-save-someones-life">Pass this along: you could save someone’s life</h1>
<p>Feel free to pass this information along to friends and family members so that we can all work together to prevent unexpected deaths resulting from undiagnosed aortic diseases.</p>
<h1 id="-5"> </h1>
<h1 id="stay-educated">Stay Educated</h1>
<p>Sign up for my weekly <a href="http://newsletters.drgraysonwheatley.com/" target="_blank" rel="noopener ugc nofollow"><strong>newsletter</strong></a><strong> </strong>to stay educated about new developments in aortic disease.</p>
<p>Take a deep dive into learning more about aortic dissections and get your copy of my book <a href="https://amzn.to/3a8QwjT" target="_blank" rel="noopener ugc nofollow"><strong>BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and The Latest Research</strong></a>.</p>
<p><img src="/uploads/3d-image-3-3.png" alt="BadAorta Volume One: Aortic Dissections: A Deep Dive Into Aortic Disease, It's Treatment And The Latest Research" title="BadAorta Volume One: Aortic Dissections: A Deep Dive Into Aortic Disease, It's Treatment And The Latest Research" width="4000" height="2667" /></p>
<p><a href="https://amzn.to/3UjspkX" target="_blank" rel="noopener">Get your copy today of BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and the Latest Research</a></p>Give me 5 minutes with a patient and I can get a very good sense of how likely it is that they have a problem with their aorta.President Abraham Lincoln’s Aortic Valve2022-08-08T00:00:00+00:002022-08-08T00:00:00+00:00http://badaorta.com/president-abraham-lincolns-aortic-valve<blockquote>
<h4 id="aortic-disease-is-called-a-silent-killer-because-there-are-often-no-warning-signs"><em>Aortic Disease is called a silent killer because there are often no warning signs</em></h4>
</blockquote>
<h2>#</h2>
<h3 id="introduction">Introduction</h3>
<p>The events of Sunday, November 8, 1963, were not meant to go down in medical history.</p>
<p>The Gettysburg Address was delivered by President Abraham Lincoln ten days later.</p>
<p>Nevertheless, a relatively standard photograph of President Abraham Lincoln taken on November 8, 1963, may hold a clue about his heart valve.</p>
<p>Additionally, medical experts would later name a diagnostic physical exam finding after him based on what they observed in that photograph.</p>
<h5 id="here-is-the-photo">Here is the photo.</h5>
<p><img src="/uploads/califmed00125-0119-a.jpg" alt="President Abraham Lincoln And His Blurry Left Foot" title="President Abraham Lincoln And His Blurry Left Foot" width="459" height="558" /></p>
<p>If you look closely at his left foot, it appears blurry.</p>
<p>His left foot may have been uncontrollably “dancing” during the photo shoot because of excessive arterial pulsation transmitted through his popliteal artery behind his left knee while crossed over his right leg.</p>
<p>The movement of his foot during the taking of the photograph is thought to have created the blurry image of his left foot.</p>
<p>Lincoln’s Sign for diagnosing aortic valve insufficiency, also referred to as aortic regurgitation, is the presence of a pulsing foot in someone with their legs crossed. (An alternative name is the Lincoln-Brooks sign of aortic insufficiency.)</p>
<p><strong>[Note: For a refresher on the aortic valve anatomy, check out our Atlas of Aortic Anatomy <a href="https://badaorta.com/aortic-atlas/" target="_blank" rel="noopener">HERE</a>]</strong></p>
<p>The prominent pulsing phenomenon is a result of insufficiency of the aortic valve, causing a prominent pulse-wave of aortic incompetence.</p>
<p><img src="/uploads/arbook.png" alt="Aortic Regurgitation" title="Aortic Regurgitation" width="787" height="573" /></p>
<p>It is purely hypothetical that President Lincoln had aortic insufficiency. One medical expert, Dr. Harold Schwartz, speculates that President Lincoln may have Marfan’s Syndrome based on the blurry foot on the photograph.</p>
<h3 id="regurgitation-of-the-aortic-valve">Regurgitation of the Aortic Valve</h3>
<p>There are four valves in the heart. Two on the left side of the heart (aortic and mitral valves) and two on the right side of the heart (tricuspid and pulmonic valves).</p>
<p>The aortic valve is the main heart valve and can degenerate in several ways.</p>
<p>The aortic valve can become excessively calcified, leading to aortic stenosis (a narrowing of the opening of the aortic valve leaflets).</p>
<p>The aortic valve can become “leaky” due to poor coaptation of the aortic valve leaflets. When the leaflets don’t come together perfectly, blood can leak back into the heart instead of moving forward towards the body.</p>
<h3 id="aortic-valve-insufficiency-causes-symptoms-and-treatment">Aortic Valve Insufficiency: Causes, Symptoms, and Treatment</h3>
<p>What is aortic valve insufficiency? Aortic valve insufficiency, also called regurgitation, occurs when the heart’s aortic valve no longer closes properly, resulting in blood leaking back into the heart. This not only causes shortness of breath but can also lead to heart failure and even death if it’s left untreated.</p>
<p>Read on to learn about the causes of aortic valve insufficiency, treatment options, and recovery timeframes. This will help you better understand this condition and know what to expect from your doctor.</p>
<h3 id="what-is-aortic-valve-insufficiency">What is aortic valve insufficiency?</h3>
<p>Aortic valve insufficiency is a progressive and debilitating heart condition that occurs when the aortic valve doesn’t close tightly enough to prevent blood from flowing backward. Aortic insufficiency affects millions of people each year and causes the heart to work harder than it should. Although there are many symptoms associated with aortic insufficiency, the most common one is shortness of breath.</p>
<p>Fortunately for those affected by this condition, treatments available can ease symptoms and improve their quality of life. Doctors may prescribe medication or suggest certain lifestyle changes to help manage aortic valve insufficiency. However, surgery is the most effective way to manage severe aortic valve insufficiency. Doctors may perform two types of surgery on patients who have developed severe cases of aortic valve regurgitation: aortic valve replacement or aortic valve repair.</p>
<h3 id="what-causes-aortic-valve-insufficiency">What causes aortic valve insufficiency?</h3>
<p>Heart valve conditions can be due to a variety of causes. Aortic valve insufficiency is caused by the weakening of the aortic valve and can lead to aortic regurgitation. This condition occurs when blood flows back into the heart from the body instead of flowing out of the heart through the aorta. If untreated, it can lead to weakening in other parts of your heart.</p>
<p>You may also experience symptoms such as chest pain or trouble breathing (shortness of breath). The earlier this condition is detected and treated, the more successful the treatment will be for patients. Early detection may save someone’s life. This is because most people with aortic valve insufficiency can die suddenly from a heart attack or stroke before they know they have any problem.</p>
<p>Another contributing factor to aortic valve insufficiency is an enlargement of the aortic root. An aortic root aneurysm can alter the geometry of the aortic annulus and create misalignment of the aortic valve leaflets.</p>
<p>Patients with aortic valve insufficiency should be screened for an aortic root aneurysm with an echocardiogram.</p>
<p>Furthermore, an aortic root aneurysm can be a problem in its own right. An aneurysm of the aortic root and ascending aorta can put someone at risk of developing an aortic dissection.</p>
<h3 id="how-is-aortic-valve-regurgitation-diagnosed">How is aortic valve regurgitation diagnosed?</h3>
<p>A diagnosis of aortic valve regurgitation can be difficult because there are a number of other things that can cause similar symptoms. A doctor will take your medical history, do an examination, and order tests to assess the function of your heart valves. If they suspect you have aortic regurgitation, they will then perform an echocardiogram or cardiac catheterization to evaluate the size of the heart valve opening.</p>
<h3 id="how-do-doctors-treat-aortic-valve-insufficiency">How do doctors treat aortic valve insufficiency?</h3>
<p>Doctors diagnose aortic valve insufficiency with a physical exam. If there’s suspicion of aortic regurgitation, doctors may order an echocardiogram to examine the heart for any leaking or ruptured valves. Once diagnosed, doctors treat aortic valve insufficiency with lifestyle changes like getting regular exercise and maintaining a healthy diet.</p>
<p>They also prescribe medication to manage high blood pressure.</p>
<p>In severe cases, surgery may be needed to correct the valve problem by replacing it with an artificial one. Using advanced techniques, it is possible in certain circumstances to repair the aortic valve.</p>
<h3 id="important-takeaways">Important Takeaways</h3>
<ul>
<li>The aortic valve is a one-way valve that regulates blood flow from the left ventricle of the heart to both the left atrium of the heart and to the rest of the body.</li>
<li>Symptoms of aortic valve insufficiency include chest pain or trouble breathing (shortness of breath)</li>
<li>If there’s suspicion of aortic regurgitation, doctors may order an echocardiogram to examine the heart for any leaking or ruptured valves.</li>
<li>Once diagnosed, doctors treat aortic valve insufficiency with medication to manage high blood pressure.</li>
<li>When the aortic valve insufficiency becomes severe, the aortic valve can be replaced or repaired.</li>
</ul>
<h3 id="references">References</h3>
<ul>
<li><a href="https://archive.org/details/lincolninphotogr00hami/page/146/mode/2up">https://archive.org/details/lincolninphotogr00hami/page/146/mode/2up</a></li>
<li>Lewis T. <a href="https://archive.org/details/b30009790/page/120">Aortic Regurgitation</a>. In: Diseases of the heart, 1933: 120-126</li>
<li>Schwartz H. Abraham Lincoln and the Marfan syndrome. JAMA 1964; 187:473–479.</li>
<li>McKusick VA. Abraham Lincoln and Marfan syndrome. Nature 1991:352:280.</li>
<li>Schwartz H. Abraham Lincoln and aortic insufficiency. The declining health of the President. Calif Med. 1972 May;116(5):82-4. PMID: 4565398; PMCID: PMC1518411.</li>
</ul>
<h2 id="-1">#</h2>
<h3 id="pass-this-along-you-could-save-someones-life">Pass this along: you could save someone’s life</h3>
<p>Feel free to pass this information along to friends and family members so that we can all work together to prevent unexpected deaths resulting from undiagnosed aortic diseases.</p>
<h2 id="-2">#</h2>
<h3 id="stay-educated">Stay Educated</h3>
<p>Sign up for my weekly <a href="http://newsletters.drgraysonwheatley.com/" target="_blank" rel="noopener ugc nofollow"><strong>newsletter</strong></a>to stay educated about new developments in aortic disease.</p>
<p>Take a deep dive into learning more about aortic dissections and get your copy of my book <a href="https://amzn.to/3a8QwjT" target="_blank" rel="noopener ugc nofollow"><strong>BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and The Latest Research</strong></a>.</p>
<p><img src="/uploads/3d-image-3-3.png" alt="BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and The Latest Research" title="BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and The Latest Research." width="4000" height="2667" /></p>
<p>Get your copy today of BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and the Latest Research</p>Lincoln’s Sign for diagnosing aortic valve insufficiency, also referred to as aortic regurgitation, is the presence of a pulsing foot in someone with their legs crossed.Ascyrus Medical Dissection Stent (AMDS) to treat acute Type A aortic dissections2019-11-24T00:00:00+00:002019-11-24T00:00:00+00:00http://badaorta.com/ascyrus-medical-dissection-stent-amds-to-treat-acute-type-a-aortic-dissections<p>Patients with acute type A aortic dissections present emergently to the hospital with a life-threatening problem of their aorta.</p>
<p>We have discussed this condition in detail <a href="/aortic-dissections-are-like-snowflakes/" target="_blank">here</a>, <a href="/acute-aortic-dissections-its-complicated/" target="_blank">here</a> and <a href="/flirting-with-disaster-acute-aortic-dissections/" target="_blank">here</a>.</p>
<p>Virtually every patient with an acute Type A aortic dissection that survives the sudden onset of the problem and makes it to the hospital requires urgent surgical repair.</p>
<p>There are many surgical treatment options for repairing the aortic dissection. The choice of which procedure to perform in each patient is individualized based on the anatomy of the aortic dissection, the association of any medical complications of the aortic dissection and surgeon preference.</p>
<p>A new technology has been developed to expand the available treatment options for patients with acute type A aortic dissection called the <a href="https://ascyrus.com" target="_blank">Ascyrus Medical Dissection Stent (AMDS).</a></p>
<p> </p>
<p><a href="https://ascyrus.com/" target="_blank"><img src="/uploads/screen-shot-2019-11-24-at-12-42-34-pm.png" alt="Ascyrus Medical Dissection Stent (AMDS) to treat acute Type A aortic dissections" title="Ascyrus Medical Dissection Stent (AMDS)" width="798" height="468" /></a></p>
<p> </p>
<p>This innovative technology consists of 2 parts.</p>
<p>First, there is a a bare metal stent which is placed in the aortic arch and proximal descending thoracic aorta which physically pushes the dissection septum back against the aortic adventitia to allow the “healing” of the aortic dissection.</p>
<p>Second, there is a a felt cuff on the proximal end of the stent which facilitates the anastomosis of the proximal aortic repair to the stent located in the aortic arch.</p>
<p>The AMDS is to be used during open heart surgery procedures and is not a totally endovascular procedure.</p>
<p>You can watch a video of an animation of the procedure on <a href="https://www.youtube.com/watch?v=YCSVcqCMDtA" target="_blank">here</a>.</p>
<p>Several research publications have been published providing information about the clinical success achieved with this technology.</p>
<p>One published study is entitled <a href="https://www.jtcvs.org/article/S0022-5223(18)32828-9/pdf" target="_blank">“Dissected Aorta Repair Through Stent Implantation trial: Canadian results”</a> in <a href="https://www.jtcvs.org/" target="_blank">The Journal of Thoracic and Cardiovascular Surgery.</a> </p>
<p> </p>
<h2><a href="https://www.jtcvs.org/article/S0022-5223(18)32828-9/pdf" target="_blank"><img src="/uploads/screen-shot-2019-11-24-at-1-05-35-pm.png" alt="Dissected Aorta Repair Through Stent Implantation trial: Canadian results" title="Dissected Aorta Repair Through Stent Implantation trial: Canadian results" width="1552" height="1212" /></a></h2>
<p> </p>
<p>16 consecutive patients with acute type A aortic dissection were treated with the AMDS with a 30-day mortality of 6.3%. 91.7% of the patients and positive remodeling of the aortic arch and proximal descending thoracic aorta.</p>
<p><a href="https://www.prweb.com/releases/ascyrus_medical_announces_ce_mark_approval_for_the_ascyrus_medical_dissection_stent_amds/prweb16070252.htm" target="_blank">In Europe, the AMDS received CE mark approval for treatment of acute type A aortic dissections in January 2019.</a></p>
<p>Recently, <a href="https://www.prweb.com/releases/fda_grants_breakthrough_device_designation_to_ascyrus_medical_dissection_stent_amds/prweb16499107.htm" target="_blank">the AMDS received Breakthrough Device Designation from the FDA to treat acute Type A aortic dissections.</a></p>
<p>This designation is a very exciting development and will help accelerate continued study of this technology in the United States.</p>
<h1 id="-1"> </h1>
<h1 id="stay-educated">Stay Educated</h1>
<p>Sign up for my weekly <a href="http://newsletters.drgraysonwheatley.com/" target="_blank" rel="noopener ugc nofollow"><strong>newsletter</strong></a><strong> </strong>to stay educated about new developments in aortic disease.</p>
<p> </p>
<p>Take a deep dive into learning more about aortic dissections and get your copy of my book <a href="https://amzn.to/3a8QwjT" target="_blank" rel="noopener ugc nofollow"><strong>BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and The Latest Research</strong></a>.</p>
<p><img src="/uploads/3d-image-3.png" alt="" width="4000" height="2667" /></p>
<p>BadAorta Volume One: Aortic Dissections: A Deep Dive Into Aortic Disease, It’s Treatment And The Latest Research</p>
<p><a href="https://amzn.to/3UjspkX" target="_blank" rel="noopener">Get your copy of BadAorta Volume One: A Deep Dive into Understanding Aortic Disease, It’s Treatments, and the Latest Research</a></p>
<p> </p>The Ascyrus Medical Dissection Stent (AMDS) to treat acute Type A aortic dissections is a novel technology for expanding the treatment options for Type A aortic dissections.Aortic Stenosis: New England Journal of Medicine2019-11-17T00:00:00+00:002019-11-17T00:00:00+00:00http://badaorta.com/aortic-stenosis-new-england-journal-of-medicine<p>Aortic stenosis is a medical condition involving disease of the aortic valve. The aortic valve of the heart functions to allow the left ventricle of the heart to eject oxygenated blood from inside the heart to the rest of the body.</p>
<p>The aortic valve opens fully to allow the exit of blood from the heart into the aorta during systole and closes to prevent regurgitation from the aorta backwards into the heart during diastole.</p>
<p>This “one way valve” concept of the aortic valve is important to maintaining adequate blood pressure and blood flow to the brain and other vital organs.</p>
<p>Aortic stenosis refers to a narrowing (stenosis) of the aortic valve area which restricts blood from exiting the heart and makes the heart muscle work harder in order to pump the blood. This creates strain on the heart muscle.</p>
<p>This narrowing of the aortic valve area also limits the amount of blood flow and blood pressure that the heart can deliver to the brain and body.</p>
<p>The aortic valve area is narrowed most commonly by a build-up of calcium on the leaflets of the aortic valve. This calcium build-up prevents the leaflets (flaps) from opening fully and can even fuse the leaflets together.</p>
<p>The end-result is a smaller sized channel through which blood must pass as it exits the heart.</p>
<p>There are generally two therapeutic approaches for aortic stenosis and the decision on which treatment approach is best is determined by a number of factors. One approach is medical therapy (blood pressure control) and the other is replacement of the aortic valve (surgical or trans catheter). The most significant factor for choosing one therapy over another relates to the severity of the aortic stenosis, but there are numerous other variables to consider (such as patient age, etc.).</p>
<p>Patients with aortic stenosis can be symptomatic, meaning they develop chest pain or shortness of breath. It is also possible to have aortic stenosis and have no symptoms at all.</p>
<p>The <a href="https://www.nejm.org" target="_blank">New England Journal of Medicine (NEJM)</a> just published a new research study comparing medical therapy versus surgical therapy for patients with asymptomatic aortic stenosis (no symptoms).</p>
<p><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1912846?query=RP" target="_blank">“Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis”. November 16, 2019DOI: 10.1056/NEJMoa1912846</a></p>
<p><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1912846?query=RP" target="_blank"><img src="/uploads/screen-shot-2019-11-17-at-9-53-58-am-1.png" alt="" width="1104" height="968" /></a></p>
<p>The authors demonstrated that early surgical intervention was better than conservative therapy for asymptomatic aortic stenosis.</p>
<p><a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1912846?query=RP" target="_blank"><img src="/uploads/screen-shot-2019-11-17-at-9-53-16-am.png" alt="" width="836" height="646" /></a></p>
<h3 id="conclusion">Conclusion</h3>
<p>This is an important research publication because it was a randomized controlled trial which helps eliminate bias in the data. We now have more information to share with patients with aortic stenosis and help in the decision making process for the type of treatment.</p>
<p>We will need additional studies to help confirm these findings, but this information is very helpful for surgeons, cardiologists, and patients.</p>Management of Asymptomatic Aortic Stenosis NEJM November 16, 2019My Mentor: Dr. Edward B. Diethrich (1935-2017)2019-08-26T00:00:00+00:002019-08-26T00:00:00+00:00http://badaorta.com/my-mentor-dr--edward-b--diethrich-1935-2017<p>I wanted to take an opportunity to recognize my mentor, Dr. Edward B. Diethrich (1935-2017), Founder and former Medical Director of the <a href="https://azheart.com" target="_blank">Arizona Heart Institute</a> in <a href="https://en.wikipedia.org/wiki/Phoenix%2C_Arizona" target="_blank">Phoenix, Arizona</a>.</p>
<p>I was fortunate to have sent 9 years working with Dr. Diethrich and the wonderful team at the Arizona Heart Institute and <a href="https://www.abrazohealth.com/our-locations/abrazo-arizona-heart-hospital" target="_blank">Hospital</a> as well as at the <a href="https://azheartfoundation.org" target="_blank">Arizona Heart Foundation</a>. </p>
<p>I will never forget all the incredible education and training he provided for me. Every day was a learning opportunity with him and he brought so many new opportunities and advances in cardiovascular surgery to his patients and staff, that you couldn’t help but grow professionally.</p>
<p>He also founded the <a href="http://isevsonline.org" target="_blank">International Society of Endovascular Specialists</a> and started the <a href="https://journals.sagepub.com/home/jet" target="_blank">Journal of Endovascular Therapies</a>.</p>
<p>I have so many wonderful stories to share from my time with him.</p>
<p>If you are interested in learning more about this incredible man, <a href="https://www.jvascsurg.org/article/S0741-5214(17)31058-3/fulltext" target="_blank">The Journal of Vascular Surgery</a> published a touching tribute to him after he passed away in 2017. Click <a href="https://www.jvascsurg.org/article/S0741-5214(17)31058-3/fulltext" target="_blank">here</a> to read it.</p>
<p>Near the end of his life, he provided us with an autobiography, called “SLED: The Serendipitous Life of Edward Diethrich”.</p>
<p>You can pick up a copy of this excellent book <a href="https://amzn.to/2Zq0dEt" target="_blank">HERE</a>.</p>
<p><a href="https://amzn.to/2Zq0dEt" target="_blank"><img src="/uploads/sleddiethrich.jpg" alt="Edward B. Diethrich, MD" title="Dr. Edward B. Diethrich" width="341" height="499" /></a></p>Dr. Edward B. Diethrich was my mentor and a pioneer in Cardiovascular Surgery.Aortic Surgery Research Review #72019-08-25T00:00:00+00:002019-08-25T00:00:00+00:00http://badaorta.com/aortic-surgery-research-review-7<p>Welcome to another edition of “This Week In Aortic Surgery”, also known as Aortic Surgery Research Review.</p>
<p>The Aortic Surgery Research Review #7 covers a range of important clinical and research topics in aortic surgery. </p>
<h5> </h5>
<h5 id="factors-influencing-the-choice-between-transcatheter-and-surgical-treatment-of-severe-aortic-stenosis-in-patients-younger-than-80years-results-from-the-observant-study"><a href="https://onlinelibrary.wiley.com/doi/10.1002/ccd.28447" target="_blank">Factors influencing the choice between transcatheter and surgical treatment of severe aortic stenosis in patients younger than 80 years: Results from the OBSERVANT study</a></h5>
<ul>
<li><a href="https://onlinelibrary.wiley.com/journal/1522726x" target="_blank">Catheterization and Cardiovascular Interventions</a></li>
</ul>
<p>“Conclusion: Among patients under 80 years of age with symptomatic severe AS, only 10% underwent TAVI. These patients were at higher baseline risk compared to those undergoing SAVR. The decision to perform TAVI was driven by the presence of both anatomical and clinical factors beyond surgical risk scores. Patients under 65 years of age, despite the low Logistic EuroSCORE, had the highest preoperative risk profile and carried the worse outcome.”</p>
<p> </p>
<h5 id="multicenter-analysis-of-endovascular-aortic-arch-in-situ-stent-graft-fenestrations-for-aortic-arch-pathologies"><a href="https://www.annalsofvascularsurgery.com/article/S0890-5096(19)30231-6/fulltext" target="_blank">Multicenter Analysis of Endovascular Aortic Arch In Situ Stent-Graft Fenestrations for Aortic Arch Pathologies</a></h5>
<ul>
<li><a href="https://www.annalsofvascularsurgery.com" target="_blank">Annals of Vascular Surgery</a></li>
</ul>
<p>“Conclusions: The aortic arch in situ fenestration technique for endovascular aortic arch repair seems to be valuable treatment option for selected patients, although initial consideration of other treatment options is mandatory. Data about long-term durability are required.”</p>
<p> </p>
<h5 id="complication-incidences-and-treatment-outcomes-of-endovascular-aneurysm-repaira-single-center-long-time-follow-up-study"><a href="https://journals.sagepub.com/doi/full/10.1177/1538574419855886" target="_blank">Complication Incidences and Treatment Outcomes of Endovascular Aneurysm Repair—A Single-Center Long-Time Follow-Up Study</a></h5>
<ul>
<li><a href="https://journals.sagepub.com/home/ves" target="_blank">Journal of Vascular and Endovascular Surgery</a></li>
</ul>
<p>“Conclusions: We presented a 10-year single-center study of EVAR. Many patients treated with EVAR had a radiological visible complication, mainly in the beginning of the follow-up period. Only a smaller fraction required reintervention and having a reintervention-requiring complication was not connected to increased mortality.”</p>
<p> </p>
<h5 id="editors-choice--five-year-outcomes-of-the-endurant-stent-graft-for-endovascular-abdominal-aortic-aneurysm-repair-in-the-engage-registry"><a href="https://www.ejves.com/article/S1078-5884(19)30034-6/fulltext" target="_blank">Editor’s Choice – Five Year Outcomes of the Endurant Stent Graft for Endovascular Abdominal Aortic Aneurysm Repair in the ENGAGE Registry</a></h5>
<ul>
<li><a href="https://www.ejves.com" target="_blank">European Journal of Vascular and Endovascular Surgery</a></li>
</ul>
<p>“Conclusions: Five year follow up of patients in the ENGAGE registry demonstrates sustained safety, effectiveness, and durability in an international cohort that is reflective of real world experience. Additional follow up is expected through to 10 years.”</p>
<p> </p>
<h5 id="rate-of-reoperation-at-1-year-for-aortic-repair-vs-replacement-in-aortic-regurgitation-a-trial-sequence-analysis-of-published-metaanalysis-results"><a href="https://onlinelibrary.wiley.com/doi/10.1111/jocs.14164" target="_blank">Rate of reoperation at 1 year for aortic repair vs replacement in aortic regurgitation. A trial sequence analysis of published meta‐analysis results</a></h5>
<ul>
<li><a href="https://onlinelibrary.wiley.com/journal/15408191" target="_blank">Journal of Cardiac Surgery</a></li>
</ul>
<p>“The pooled estimate of a recent meta‐analysis concluded that rate of reoperation at 1 year was significantly higher in Aortic valve repair (8.82% vs 3.70%) as compared with aortic valve replacement in patients with aortic regurgitation (odds ratio = 2.67, 95% confidence interval [1.08, 3.62], <em>P</em> = .03). We performed a trial sequential analysis using the published data of the meta‐analysis and found the evidence is not strong enough for the conclusion.”</p>
<h5 id="-1"> </h5>
<p>Feel free to pass along any suggestions or recommendations for a recently published research study in aortic surgery or aortic disease management that you think would be good for us to include.</p>
<p>You can send me a <a href="mailto:info@badaorta.com?subject=Suggested%20Research%20Study">note</a> with information about the study and I will gladly consider including it in my weekly roundup. (<a href="mailto:info@badaorta.com?subject=Suggested%20article%20for%20This%20Week%20in%20Aortic%20Surgery">info at badaorta.com</a>)</p>
<p><em>About Us:</em></p>
<p><em>We offer a curated selection of top research articles each week which are hand-picked from leading surgical journals.</em></p>
<p><em>We save you time by reviewing numerous publications each week and provide you with a careful selection of high-impact research studies in Aortic Surgery.</em></p>
<p><em>We do the heavy lifting of sifting through current surgical journals to bring together key research articles which provide a real-world perspective on important aspects of Aortic Surgery.</em></p>
<p><em>We include a wide-range of publications in specialties ranging from Cardiac Surgery, Vascular Surgery, Minimally Invasive Surgery, Endovascular Surgery, Interventional Cardiology and Interventional Radiology.</em></p>We save you time by reviewing numerous publications each week and provide you with a carefully selected snapshot of high-impact research studies in Aortic Surgery.Multilayer Stent For Acute and Chronic Aortic Dissections Research Poster (ISMICS)2019-08-21T00:00:00+00:002019-08-21T00:00:00+00:00http://badaorta.com/multilayer-stent-for-acute-and-chronic-aortic-dissections-research-poster-ismics<p>For those of you who aren’t familiar with the <a href="https://scholar.google.com/scholar?q=multi-layer+flow+modulating+stents&hl=en&as_sdt=0&as_vis=1&oi=scholart" target="_blank">multi-layer flow-modulating stent technology</a> (MFM) for treating aortic aneurysms and aortic dissections, you should take the time to learn more about this <a href="https://www.jvascsurg.org/article/S0741-5214(17)30009-5/pdf" target="_blank">novel and disruptive technology</a>.</p>
<p>This technology is produced by a medical device company out of Europe called <a href="http://www.cardiatis.com" target="_blank">Cardiatis</a>.</p>
<p>The multi-layer flow modulated stent technology takes advantage of the flow dynamics of blood as it interacts with the wire frame of the stents. </p>
<p>This technology is not yet available in the United States, but is <a href="https://medtech.pharmaintelligence.informa.com/MT101522/Clinicas-MedTech-Ventures-Cardiatis" target="_blank">available in Europe</a>.</p>
<p>Recently, we presented the <a href="http://meetings.ismics.org/abstracts/2019/PC4.cgi" target="_blank">results and outcomes of using the multi-layer Flow-Modulating Stents to treat aortic dissections involving the thoracoabdominal aorta and the aortic arch</a> at <a href="http://ismics.org" target="_blank">The International Society of Minimally Invasive Cardiothoracic Surgery</a> <a href="http://meetings.ismics.org/abstracts/2019-Masters-Day.cgi" target="_blank">19th Annual Meeting in New York, NY</a>.</p>
<p>This work was done in association with <a href="https://www.clinicapolisano.ro/operatie-premiera-chirurgul-victor-costache-intrat-academia-recordurilor-mondiale/" target="_blank">Dr. Victor Costache</a> in <a href="https://en.wikipedia.org/wiki/Sibiu" target="_blank">Sibiu, Romania</a> at the <a href="http://nextcardio.ro" target="_blank">NEXTCardio Research Institute</a> and the <a href="https://translate.google.com/translate?hl=en&sl=ro&u=http://www.clinicapolisano.ro/&prev=search" target="_blank">Polisano Clinic</a>.</p>
<p><img src="/uploads/ismicsposter2019-1.png" alt="ISMICS 2019 Multilayer Stent to Treat Thoracoabdominal Aortic Dissections" title="ISMICS 2019 Multilayer Stent to Treat Chronic Thoracoabdominal Dissections" width="720" height="405" /></p>
<p><a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=victor+costache" target="_blank">Victor Costache</a>, Ovidiu Stiru, <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=kak+yeung" target="_blank">Kak Yeung</a>, Andreea Costache, Crina Solomon, Tatiana Melnic, Mihai Sandu, <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=rodney+white" target="_blank">Rodney White</a>, <a href="https://www.ncbi.nlm.nih.gov/pubmed/?term=grayson+wheatley" target="_blank">Grayson H. Wheatley III</a></p>
<p><strong>Background</strong>: Reported are up to 48 month single center outcomes of patients with thoracoabdominal aortic dissection managed by new generation Multilayer Flow Modulator stents. We present our single center experience with this novel endovascular technique together with up to 4 years clinical, imaging and ComputanionalFluid Dynamics (CFD) data. Primaryendpoints were procedural success, overall one-year survival, freedom from aortic rupture and freedom from dissection-related death at 12 months. Secondary endpoints were freedom from major adverse events, freedom from graft rupture, freedom from major side branches occlusion, and aortic remodelling by false lumen index calculation.</p>
<p><strong>Patients:</strong> Between April 2014 and February 2019, 23 patients with complex thoracoabdominalaortic dissection were prospectively included. All patients (mean age = 51.1 ±12.8 years, 78.3 % males) had either type B aortic dissection (N=14) or residual thoracoabdominaldissection after surgery for type A (N=9). All patients presented with multiple comorbidities and were all considered high surgical risk.</p>
<p><strong>Methods:</strong> This study is a prospective single center analysis of patients with complex thoracoabdominalaortic dissection that underwent endovascular repair using new generation MFM stents. Patients were followed prospectively, with regular visit at 1 month, 3 months, 6 months and then on a yearly basis. During visits, data on adverse events, blood samples and high resolution CT scans were obtained. Morphologic computerized fluid dynamics (CFD) analysis was performed at each follow-up with MIMICS software to measure dissection remodellingand changes of the transversal diameter and volumes of true and false lumen compared pre- and post-operatively, while ANSYS software was used for aortic flow and pressure measurements.</p>
<p><img src="/uploads/picture7ismics.png" alt="Computative Flow Dynamics of Aortic Dissections" title="Computative Flow Dynamics of Aortic Dissections" width="889" height="308" /></p>
<p><strong>Results:</strong> 23 patients with aortic dissection, underwent thoracic endovascular aortic repair (TEVAR) with a new generation multilayer aortic stents. </p>
<p><strong>Primary endpoints:</strong></p>
<p>•no patients were lost to follow-up with the longest follow-up of 48 months and an average follow-up of 18 months</p>
<p>•Initial procedural success was 100%</p>
<p>•One-year survival was 100%</p>
<p>•There were 0 reported ruptures and 0 aortic-related deaths</p>
<p><strong>Secondary end points</strong>:</p>
<p>•Freedom from major adverse events was 95.7%. In one case a retrograde dissection was observed</p>
<p>•Freedom from graft rupture was 100%</p>
<p>•Freedom from major side branches occlusion was 100%. No renal insult, end-organ ischemia or paraplegia was observed</p>
<p>•Geometrical analysis and CFD confirmed remodelling by a true lumen diameter and volume increase postoperatively (p<0.001) and false lumen diameter and volume decrease (p<0.001)</p>
<p><img src="/uploads/picture5ismics.png" alt="True Lumen Volume following treatment with Multi-Layer Flow Modulating Stent" title="True Lumen Volume following treatment with Multi-Layer Flow Modulating Stent" width="541" height="285" /></p>
<p><img src="/uploads/picture6ismics.png" alt="True Lumen Diameter following treatment with Multi-Layer Flow Modulating Stent" title="True Lumen Diameter following treatment with Multi-Layer Flow Modulating Stent" width="510" height="356" /></p>
<p><strong>Conclusions:</strong> In our cohort, multilayer flow modulator stents seem to be safe option in the treatment of patients with complex thoracoabdominal aortic dissections with good procedural success, and with few post-procedural complications and no dissection related mortality</p>
<p>•Total coverage of all supra-aortic trunks and complete coverage of renal and spinal arteries with this disruptive technology does not lead to end-organ ischemia or neurological complications</p>
<p>•Further research and long-term outcomes are needed to address safety, clinical efficacy and patency of multilayer flow modulator stents</p>Outcomes of patients with thoracoabdominal aortic dissection managed by new generation Multilayer Flow Modulator stents.