Aortic endovascular repair modeling using the finite element method

Abstract

Aim: The goal is to simulate different stages of the endovascular procedure in the preoperative phase. Methods: We have developed a numerical model of the endovascular treatment of abdominal aortic aneurysms (AAA) using finite element analysis (FEA), we took into account the geometry of the biological region reconstructed from scans, a local characterization of the guidewire/catheter mechanical properties, a mapping of material properties depending on the degree of calcification, a real behavior of the vascular walls, and a projection of the aorta environment. Results: Our results present the endovascular system navigation from the femoral artery to the neck of the aneurysm, predict the deformation of femoral, iliac and aortic arteries while driving flexible and stiff endovascular devices, and detect stress concentration due to tortuous and calcified artery zones. A given group of patients with very angulated and calcified arteries were validated, based on a tuning between clinical data and our endovascular simulation. Conclusion: Our model allows controlling with accuracy the delivery system rise during surgery, predicting the feasibility of the surgery with reliability as well as choose the best guide for each patient, taking into account the risk of rupture of calcified areas in the case of high angulations, and using planning simulated images with deformation of artery walls to propose stent sizing.

Finite element simulation of the insertion of guidewires during an EVAR procedure: example of a complex patient case, a first step toward patient‐specific parameterized models

“…However, the published results were compared with only 2D intraoperative data, and the implicit method used showed convergence difficulties when facing tortuous anatomies. Finally, Mouktadiri et al showed the feasibility of the use of the explicit finite element method in the simulation of the insertion of endovascular devices; however, no extra‐stiff guidewires were modeled and no quantitative information regarding comparisons with intraoperative data was presented.…”

“…The simulation is presented on a patient‐specific case involving a complex anatomy in order to prove the feasibility of the method, and the results are compared with 3D imaging data acquired during the surgical procedure. The support provided by surrounding organs and bones structures is taken into account in a more realistic way than what was proposed in previous publications . As very few clinical or experimental data are available concerning this particular aspect, we carried out a sensitivity study to understand the effect of the parameters introduced to model the external support.…”

Target vessel displacement during fenestrated and branched endovascular aortic repair and its implications for the role of traditional computed tomography angiography roadmaps

“…Another fast-developing strategy to resolve the mismatch between the real-time anatomy and the image fusion roadmap, is the use of deformable (dynamic) image fusion applications (18)(19)(20)(21). These applications generate a deformable model of the vascular geometry, in which the distance between certain subsections can be modified or stretched to allow dynamic corrections to match with the real-time anatomy.…”

A Robotic Platform For Endovascular Aneurysm Repair

“…The guide is inserted at a constant speed and angle and the model calculates the dynamic deformation of the aorta at the passage of the guide as well as the stress distribution in the structure. More details are available in [6]. Figure 8 shows the deformations caused by the insertion of different guides as well as the stress distribution in the aorta.…”