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A methodology for in silico endovascular repair of abdominal aortic aneurysms

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Abstract

Endovascular aneurysm repair (EVAR) can involve some unfavorable complications such as endoleaks or stent-graft (SG) migration. Such complications, resulting from the complex mechanical interaction of vascular tissue, SG and blood flow or incompatibility of SG design and vessel geometry, are difficult to predict. Computational vascular mechanics models can be a predictive tool for the selection, sizing and placement process of SGs depending on the patient-specific vessel geometry and hence reduce the risk of potential complications after EVAR. In this contribution, we present a new in silico EVAR methodology to predict the final state of the deployed SG after intervention and evaluate the mechanical state of vessel and SG, such as contact forces and wall stresses. A novel method to account for residual strains and stresses in SGs, resulting from the precompression of stents during the assembly process of SGs, is presented. We suggest a parameter continuation approach to model various different sizes of SGs within one in silico EVAR simulation which can be a valuable tool when investigating the issue of SG oversizing. The applicability and robustness of the proposed methods are demonstrated on the example of a synthetic abdominal aortic aneurysm geometry.

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Notes

  1. According to Beier and Neely (1992) who introduced the term “control primitives”.

  2. Obviously the orthogonality property of the triad according to Eqs. (5c) and (5d) has to be preserved.

  3. The methodology can easily be extended to SG models with an uncovered stent in the proximal landing zone. However, such SG designs are not considered here for now.

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Acknowledgements

The authors gratefully acknowledge support and funding by the Leibniz Rechenzentrum München (LRZ) of the Bavarian Academy of Sciences under contract number pr48ta.

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Authors and Affiliations

  1. Mechanics and High Performance Computing Group, Technische Universität München, Parkring 35, 85748, Garching b. München, Germany

    André Hemmler & Michael W. Gee

  2. Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Germany

    Brigitta Lutz & Christian Reeps

  3. Klinik für vaskuläre und endovaskuläre Chirurgie, DRK Kliniken Berlin, Salvador-Allende-Straße 2-8, 12559, Berlin, Germany

    Günay Kalender

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  1. André Hemmler
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Hemmler, A., Lutz, B., Reeps, C. et al. A methodology for in silico endovascular repair of abdominal aortic aneurysms. Biomech Model Mechanobiol 17, 1139–1164 (2018). https://doi.org/10.1007/s10237-018-1020-0

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