Patient-specific simulation of stent-graft deployment within an abdominal aortic aneurysm

In this study, finite element analysis is used to simulate the surgical deployment procedure of a bifurcated stent-graft on a real patient's arterial geometry. The stent-graft is modeled using realistic constitutive properties for both the stent and most importantly for the graft. The arterial geometry is obtained from pre-operative imaging exam. The obtained results are in good agreement with the post-operative imaging data. As the whole computational time was reduced to less than 2 hours, this study constitutes an essential step towards predictive planning simulations of aneurysmal endovascular surger

Study of a medical device to treat aortic dissection with Finite Element Analysis

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2022-2023. Tutor/Director: Carmona Flores, Manuel, Soudah Prieto, EduardoThe aortic dissection is a cardiovascular disease that results from the rupture of the inner layer of the aorta. Type B aortic dissections commonly become a chronic disease with a high long-term morbidity and mortality rates. Current treatments include open surgery repair and thoracic endovascular aortic repair (TEVAR). However, new non-invasive treatments are being developed that favour the own regeneration of the tissue, avoiding the permanent presence of a foreign device in the body. This project focuses on the understanding of a new treatment with a medical device, an aortic patch, by in silico testing. The goal is to determine the performance of the patch in a simulated aortic dissection and then compare it with the current treatment with the stent graft (TEVAR), to determine if it would avoid the hypertension that can be caused by the stent. To do the first part, it was created a model of the aortic dissection, but due to complications with the simulation, this part of the project couldn’t be finished, and the performance of the patch in the aortic dissection couldn’t be determined. To do the second part three models were created: healthy aorta, aortic dissection with stent graft and aortic dissection with patch. A transient simulation was run for the three models and the pressure waveform was analyzed. The results show that the pressure in the stent graft model is higher, and the patch has a similar response to the healthy aorta. However, all the models presented hypertension (including the healthy aorta) and the differences between the models are too small to be concluding, so it cannot be assured that the patch is a better option than the stent graft to avoid causing hypertension in the aortic dissection treatment

Optimization of CT scanning protocol of Type B aortic dissection follow-up through 3D printed model

This research aims to develop and evaluate a human tissue-like material 3D printed model used as a phantom in determining optimized scanning parameters to reduce the radiation dose for Type B aortic dissection patients after thoracic endovascular aortic repair. The results show that radiation risk for follow-up Type B aortic dissection patients can be potentially reduced. Further, the value of using 3D printed model in studying CT scanning protocols was further validated

Investigation of the Hemodynamic Effect of Stent Wires on Renal Arteries in Patients with Abdominal Aortic Aneurysms Treated with Suprarenal Stent-Grafts

The purpose of the study was to investigate the hemodynamic effect of stent struts (wires) on renal arteries in patients with abdominal aortic aneurysms (AAAs) treated with suprarenal stent-grafts. Two sample patients with AAA undergoing multislice CT angiography pre- and postsuprarenal fixation of stent-grafts were selected for inclusion in the study. Eight juxtarenal models focusing on the renal arteries were generated from the multislice CT datasets. Four types of configurations of stent wires crossing the renal artery ostium were simulated in the segmented aorta models: a single wire crossing centrally, a single wire crossing peripherally, a V-shaped wire crossing centrally, and multiple wires crossing peripherally. The blood flow pattern, flow velocity, wall pressure, and wall shear stress at the renal arteries pre- and post-stent-grafting were analyzed and compared using a two-way fluid structure interaction analysis. The stent wire thickness was simulated with a diameter of 0.4, 1.0, and 2.0 mm, and hemodynamic analysis was performed at different cardiac cycles. The interference of stent wires with renal blood flow was mainly determined by the thickness of stent wires and the type of configuration of stent wires crossing the renal ostium. The flow velocity was reduced by 20–30% in most of the situations when the stent wire thickness increased to 1.0 and 2.0 mm. Of the four types of configuration, the single wire crossing centrally resulted in the highest reduction of flow velocity, ranging from 21% to 28.9% among three different wire thicknesses. Wall shear stress was also dependent on the wire thickness, which decreased significantly when the wire thickness reached 1.0 and 2.0 mm. In conclusion, our preliminary study showed that the hemodynamic effect of suprarenal stent wires in patients with AAA treated with suprarenal stent-grafts was determined by the thickness of suprarenal stent wires. Research findings in our study are useful for follow-up of patients treated with suprarenal stent-grafts to ensure long-term safety of the suprarenal fixation

Patient-specific simulation of stent-graft deployment in type B aortic dissection: model development and validation

Thoracic endovascular aortic repair (TEVAR) has been accepted as the mainstream treatment for type B aortic dissection, but post-TEVAR biomechanical-related complications are still a major drawback. Unfortunately, the stent-graft (SG) configuration after implantation and biomechanical interactions between the SG and local aorta are usually unknown prior to a TEVAR procedure. The ability to obtain such information via personalized computational simulation would greatly assist clinicians in pre-surgical planning. In this study, a virtual SG deployment simulation framework was developed for the treatment for a complicated aortic dissection case. It incorporates patient-specific anatomical information based on pre-TEVAR CT angiographic images, details of the SG design, and the mechanical properties of the stent wire, graft and dissected aorta. Hyperelastic material parameters for the aortic wall were determined based on uniaxial tensile testing performed on aortic tissue samples taken from type B aortic dissection patients. Pre-stress conditions of the aortic wall and the action of blood pressure were also accounted for. The simulated post-TEVAR configuration was compared with follow-up CT scans, demonstrating good agreement with mean deviations of 5.8% in local open area and 4.6 mm in stent strut position. Deployment of the SG increased the maximum principal stress by 24.30 KPa in the narrowed true lumen but reduced the stress by 31.38 KPa in the entry tear region where there was an aneurysmal expansion. Comparisons of simulation results with different levels of model complexity suggested that pre-stress of the aortic wall and blood pressure inside the stent-graft should be included in order to accurately predict the deformation of the deployed S