3D Reconstruction and Manufacture of Real Abdominal Aortic Aneurysms: From CT Scan to Silicone Model

Doyle, Barry; Morris, Liam; Callanan, Anthony; Kelly, Pat; Vorp, David A.; McGloughlin, Timothy M.

doi:10.1115/1.2907765

Cited by 68 publications

(70 citation statements)

References 19 publications

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“…6,11,12 Each experimental model was imaged using CT before testing to generate accurate numeric reconstructions for validation purposes using previously reported 3D reconstruction techniques and the commercially available software Mimics (Materialise). 16,23,36 Rupture occurred at the location of numerically predicted peak wall stress in 80% of cases and at high, but not peak, stress regions in 10% of cases. These sites were also shown to be regions of complex gaussian surface curvature 40 and correlated well with the stress patterns observed using photoelastic stress analysis on the same geometry.…”

Section: Experimental Aaa Rupture Riskmentioning

confidence: 99%

“…13,17,35 It is now possible to create patient-specific rubber AAA models 36 that are nonuniform in wall strength 35 similar to the in vivo situation. 31 These models can then be studied using the rupture technique reported by the authors.…”

Section: Computational Aaa Rupture Riskmentioning

confidence: 99%

“…To facilitate validation of numeric models, it is now possible to create patient-specific experimental AAA models by rapid prototyping 37 or injection molding, 36,38 with the latter technique shown to create repeatable anatomically correct benchtop models for a variety of in vitro modeling applications. 36 To develop accurate representations of the AAA wall, a technique has been reported that can manufacture silicone AAA models with random or controlled material properties, with methods in place to nondestructively assess these material properties. 35 It has also recently been demonstrated that the intraluminal thrombus, which may significantly influence the rupture site, can be included in experimental models.…”

Section: Experimental Aaa Rupture Riskmentioning

confidence: 99%

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New Approaches to Abdominal Aortic Aneurysm Rupture Risk Assessment

McGloughlin

Doyle²

2010

ATVB

109

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Abstract-Abdominal aortic aneurysm (AAA) rupture remains a significant cause of death in the developed world. Current treatment approaches rely heavily on the size of the aneurysm to decide on the most appropriate time for clinical intervention and treatment. However, in recent years, several alternative rupture risk indicators have been proposed. This brief review examines some of these new approaches to AAA rupture risk assessment, from both numeric and experimental aspects and also what the future may hold for AAA rupture risk. Although numerically predicted wall stress, finite element analysis rupture index, rupture potential index, severity parameter, and geometric factors, such as asymmetry, have all been developed and show promise in possibly helping to predict AAA rupture risk, validation of these tools remains a significant challenge. Validation of biomechanics-based rupture indicators may be feasible by combining in vitro modeling of realistic AAA analogues with both retrospective and prospective monitoring and modeling of AAA cases. Peak wall stress is arguably the primary result obtained from numeric analyses; however, as the majority of ruptures occur in the posterior and posterior-lateral regions, the role of posterior wall stress has also recently been highlighted as potentially significant. It is also known that wall stress alone is not enough to cause rupture, as wall strength plays an equal role. Therefore, should a biomechanics-based rupture risk be implemented? There have been some significant steps, both numerically and experimentally, toward answering this and other questions relating to AAA rupture risk prediction, yet regardless of the efforts that are under way in several laboratories, the introduction of a numerically predicted rupture risk parameter into the clinicians' decision-making process may still be quite some time away. Key Words: aneurysms Ⅲ risk factors Ⅲ experimental modeling Ⅲ numerical modeling Ⅲ review Ⅲ rupture risk A pproximately 81 million people in the United States are currently living with one of the many forms of cardiovascular disease. Of this affected population, it is estimated that about 900 000 will die each year. Abdominal aortic aneurysm (AAA) is a dilation of the aorta beyond 50% of the normal vessel diameter, and it accounts for approximately 15 000 deaths per year in the United States. 1 AAA rupture risk is typically determined by size, and it has been shown that in the 5 years following AAA diagnosis, rupture occurs in approximately 2% of AAAs less than 4 cm in diameter and in more than 25% of AAAs larger than 5 cm. 2,3 Current clinical practice is to surgically repair large AAAs (diameter Ͼ5.5 cm) if the patient is fit for surgery or to regularly monitor (eg, every 6 months) smaller AAAs (diameter Ͻ5.5 cm) with ultrasound, with referral for surgery if the growth rate exceeds 1 cm/year or the diameter exceeds 5.5 cm. 3 However, surgeons need to compare the risk of rupture with the risk of repair, as it has been reported that only 25% of AAAs rupture in a...

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Section: Experimental Aaa Rupture Riskmentioning

confidence: 99%

Section: Computational Aaa Rupture Riskmentioning

confidence: 99%

Section: Experimental Aaa Rupture Riskmentioning

confidence: 99%

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New Approaches to Abdominal Aortic Aneurysm Rupture Risk Assessment

McGloughlin

Doyle²

2010

ATVB

109

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“…3D reconstructions were performed using the commercial software Mimics v10.0 (Materialise, Belgium). This reconstruction technique was validated with previous work performed by our group [26,27]. The iliac arteries were omitted from the reconstruction as they have been shown not to significantly alter the resulting wall stress distributions [10].…”

Section: Study Subjects and Reconstructionsmentioning

confidence: 97%

A Finite Element Analysis Rupture Index (FEARI) as an Additional Tool for Abdominal Aortic Aneurysm Rupture Prediction

Doyle¹,

Callanan²,

Walsh³

et al. 2009

VDP

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Currently, abdominal aortic aneurysms (AAAs), which are a permanent dilation of the aorta, are treated surgically when the maximum transverse diameter surpasses 5.5cm. AAA rupture occurs when the locally acting wall stress exceeds the locally acting wall strength. There is a need to review the current diameter-based criterion, and so it may be clinically useful to develop an additional tool to aid the surgical decision-making process. A Finite Element Analysis Rupture Index (FEARI) was developed.Ten patient-specific AAAs were reconstructed, and the corresponding wall stress computed. Previous experimental work on determination of ultimate tensile strengths (UTS) from AAA tissue samples was implemented in this study. By combining peak wall stress along with average regional UTS, a new approach to the estimation of patient-specific rupture risk has been developed.Ten cases were studied, all of which were awaiting or had previously undergone surgical AAA repair. A detailed examination of these ten cases utilising the FEARI analysis suggested that there was a possibility that some of the AAAs may have been less prone to rupture than previously considered.It is proposed that FEARI, used alongside other rupture risk factors, may improve the current surgical decision-making process. The use of FEARI as an additional tool for rupture prediction may provide a useful adjunct to the diameter-based approach in surgical decision-making.

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“…The CT DICOM data were imported into Mimics v16 to reconstruct patient-specific 3-D models of the thoracic aorta using the algorithm introduced by Doyle et al 10 Three steps were required to reconstruct 3-D models from CT data using Mimics. First, a thresholding technique was applied to the imported CT data to highlight the areas of interest, which is called rudimentary segmentation.…”

Section: Imaging Protocols and 3-d Reconstructionmentioning

confidence: 99%

Rate of Stenotic Bicuspid Aortic Valve Aortic Dilatation After Aortic Valve Replacement, Calculated Using a 3-Dimensional Reconstruction Tool

Hattori

Fukuda

Daitoku

et al. 2017

Circ J

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0.18±0.08 mm/m 2 after AVR. 9 The annual progression rate of BAV aortas, however, remains controversial, because the diameter of asymmetric dilated aorta is difficult to measure accurately on conventional computed tomography (CT). We postulated that the progression of ascending aortic diameter in BAV patients depends on its direction, because the dilated ascending aorta with BAV is expected to progress more rapidly toward the right-anterior quadrant, where WSS should be greater. 8 The aim of the present study was therefore to measure aortic diameter in the right-anterolateral direction in order to calculate an accurate progression rate of the asymmetric dilated ascending aorta after AVR. Aortic diameter was measured using 3-dimensional (3-D) reconstruction and an automated analysis tool, Mimics (Materialise, Leuven, Belgium), and the annual progression rate was compared between BAV and tricuspid aortic valve (TAV) patients. Methods Patient SelectionData derived from 28 patients (male, n=18; 64%; female, B icuspid aortic valve (BAV) is a common congenital heart malformation that occurs in 0.5-2% of the population. 1,2 Patients with BAV are at increased risk of developing serious aortic complications, including aortic dilatation, dissection and rupture after reaching adulthood. 2-4 The valve-related aortic complications, called BAV-related aortopathy, occur in 10-35%, and aortic dissection occurs in approximately 4% of patients with BAV. 3 Patients with BAV and dilated aorta have a 9-fold increased risk of aortic dissection. 5 On histology, aortas with BAV frequently show cystic medial degeneration, a characteristic histopathological defect of the aortic media. 3,5Ascending aortic dilatation associated with BAV frequently has an asymmetric configuration that bulges toward the right-anterior aspect of the aorta. 6 The asymmetric enlargement might be caused by valve-related hemodynamic abnormalities, which lead to the asymmetric distribution of wall shear stress (WSS). 7, 8 Yasuda et al reported that ascending aortic dilatation associated with BAV sometimes progresses even after aortic valve replacement (AVR). 9 They reported that the ascending aortic diameter increased at an annual rate of Background: Progression of asymmetric dilated aorta associated with bicuspid aortic valve (BAV) is difficult to evaluate conventionally. The aim of the study was to calculate the rate of progression of the dilated BAV aorta after aortic valve replacement (AVR) using a 3-dimensional (3-D) reconstruction tool.

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3D Reconstruction and Manufacture of Real Abdominal Aortic Aneurysms: From CT Scan to Silicone Model

Cited by 68 publications

References 19 publications

New Approaches to Abdominal Aortic Aneurysm Rupture Risk Assessment

New Approaches to Abdominal Aortic Aneurysm Rupture Risk Assessment

A Finite Element Analysis Rupture Index (FEARI) as an Additional Tool for Abdominal Aortic Aneurysm Rupture Prediction

Rate of Stenotic Bicuspid Aortic Valve Aortic Dilatation After Aortic Valve Replacement, Calculated Using a 3-Dimensional Reconstruction Tool

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