title: Patient-specific numerical simulation of stent-graft deployment: Validation on three clinical cases.
abstract: Endovascular repair of abdominal aortic aneurysms faces some adverse outcomes, such as kinks or endoleaks related to incomplete stent apposition, which are difficult to predict and which restrain its use although it is less invasive than open surgery. Finite element simulations could help to predict and anticipate possible complications biomechanically induced, thus enhancing practitioners' stent-graft sizing and surgery planning, and giving indications on patient eligibility to endovascular repair. The purpose of this work is therefore to develop a new numerical methodology to predict stent-graft final deployed shapes after surgery. The simulation process was applied on three clinical cases, using preoperative scans to generate patient-specific vessel models. The marketed devices deployed during the surgery, consisting of a main body and one or more iliac limbs or extensions, were modeled and their deployment inside the corresponding patient aneurysm was simulated. The numerical results were compared to the actual deployed geometry of the stent-grafts after surgery that was extracted from postoperative scans. We observed relevant matching between simulated and actual deployed stent-graft geometries, especially for proximal and distal stents outside the aneurysm sac which are particularly important for practitioners. Stent locations along the vessel centerlines in the three simulations were always within a few millimeters to actual stents locations. This good agreement between numerical results and clinical cases makes finite element simulation very promising for preoperative planning of endovascular repair.
authors.affiliation: Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, CNRS: UMR5307, LGF, F-42023 Saint-Etienne, France; CNRS, 3SR Lab, F-38000 Grenoble, France; Université Grenoble Alpes, 3SR Lab, F-38000 Grenoble, France.
authors.forename: David
authors.initials: D
authors.lastname: Perrin
authors.affiliation: Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, CNRS: UMR5307, LGF, F-42023 Saint-Etienne, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Badel
authors.affiliation: CNRS, 3SR Lab, F-38000 Grenoble, France; Université Grenoble Alpes, 3SR Lab, F-38000 Grenoble, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Orgéas
authors.affiliation: CNRS, 3SR Lab, F-38000 Grenoble, France; Université Grenoble Alpes, 3SR Lab, F-38000 Grenoble, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Geindreau
authors.affiliation: INSERM, U1099, F-35000 Rennes, France; Université de Rennes 1, LTSI, F-35000 Rennes, France; Therenva, F-35000 Rennes, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Dumenil
authors.affiliation: CHU Hôpital Nord Saint-Etienne, Department of CardioVascular Surgery, Saint-Etienne F-42055, France; Université Jean Monnet, GRT EA 3065, Saint-Etienne F-42023, France.
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Albertini
authors.affiliation: Ecole Nationale Supérieure des Mines de Saint-Etienne, CIS-EMSE, CNRS: UMR5307, LGF, F-42023 Saint-Etienne, France. Electronic address: avril@emse.fr.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Avril
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000209:etiology / Q000601:surgery*; D001696:Biomechanical Phenomena; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003198:Computer Simulation; D020342:Finite Element Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D057234:Preoperative Period; D015607:Stents; D016896:Treatment Outcome
keywords: Abdominal aortic aneurysm; Endovascular repair; Finite-element analysis; Patient-specific; Stent-graft