Deformable Surface Model for the Evaluation of Abdominal Aortic Aneurysms Treated with an Endovascular Sealing System.
Rupture of abdominal aortic aneurysms (AAA) is responsible for 1-3% of all deaths among the elderly population in developed countries. A novel endograft proposes an endovascular aneurysm sealing (EVAS) system that isolates the aneurysm wall from blood flow using a polymer-filled endobag that surrounds two balloon-expandable stents. The volume of injected polymer is determined by monitoring the endobag pressure but the final AAA expansion remains unknown. We conceived and developed a fully deformable surface model for the comparison of pre-operative sac lumen size and final endobag size (measured using a follow-up scan) with the volume of injected polymer. Computed tomography images were acquired for eight patients. Aneurysms were manually and automatically segmented twice by the same observer. The injected polymer volume resulted 9% higher than the aneurysm pre-operative lumen size (p < 0.05), and 11% lower than the final follow-up endobag volume (p < 0.01). The automated method required minimal user interaction; it was fast and used a single set of parameters for all subjects. Intra-observer and manual vs. automated variability of measured volumes were 0.35 ± 2.11 and 0.07 ± 3.04 mL, respectively. Deformable surface models were used to quantify AAA size and showed that EVAS system devices tended to expand the sac lumen size.
Facultad de Ingeniería Ciencias Exactas y Naturales, Favaloro University, Solís 453, 1078, Ciudad Autónoma de Buenos Aires, Argentina.|Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
Mariano E
ME
Casciaro
Service de Chirurgie Cardiaque et Vasculaire, Paris, France.|Université Paris-Descartes, Paris, France.|Unité de Recherche en Développement, Imagerie et Anatomie, EA 4465, Université Paris 5, Paris, France.
Salma
S
El-Batti
APHP, Centre de Médecine Préventive Cardiovasculaire, Hôpital Européen Georges Pompidou, Paris, France.|INSERM U970, Paris, France.|Université Paris-Descartes, Paris, France.
Gilles
G
Chironi
APHP, Centre de Médecine Préventive Cardiovasculaire, Hôpital Européen Georges Pompidou, Paris, France.|INSERM U970, Paris, France.|Université Paris-Descartes, Paris, France.
Alain
A
Simon
INSERM U970, Paris, France.|Université Paris-Descartes, Paris, France.|Service d'Imagerie Cardiovasculaire, Paris, France.
Elie
E
Mousseaux
Facultad de Ingeniería Ciencias Exactas y Naturales, Favaloro University, Solís 453, 1078, Ciudad Autónoma de Buenos Aires, Argentina.
Ricardo L
RL
Armentano
INSERM U970, Paris, France.|Service de Chirurgie Cardiaque et Vasculaire, Paris, France.|Université Paris-Descartes, Paris, France.
Jean-Marc
JM
Alsac
Facultad de Ingeniería Ciencias Exactas y Naturales, Favaloro University, Solís 453, 1078, Ciudad Autónoma de Buenos Aires, Argentina. dcraiem@favaloro.edu.ar.|Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina. dcraiem@favaloro.edu.ar.|APHP, Centre de Médecine Préventive Cardiovasculaire, Hôpital Européen Georges Pompidou, Paris, France. dcraiem@favaloro.edu.ar.|INSERM U970, Paris, France. dcraiem@favaloro.edu.ar.|Université Paris-Descartes, Paris, France. dcraiem@favaloro.edu.ar.
Damian
D
Craiem
D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008955:Models, Cardiovascular; D014057:Tomography, X-Ray Computed
Abdominal aorta; Endograft; Endovascular repair; Geometrical deformed model; Nellix device