In silico study of vessel and stent‐graft parameters on the potential success of endovascular aneurysm repair

The variety of stent-graft (SG) design variables (e.g. SG type and degree of SG oversizing) and the complexity of decision making whether a patient is suitable for endovascular aneurysm repair (EVAR) raise the need for the development of pre- dictive tools to assist clinicians in the preinterventional planning phase. Recently, some in silico EVAR methods have been developed to predict the deployed SG con- figuration. However, only few studies investigated how to assess the in silico EVAR outcome with respect to EVAR complication likelihoods (e.g. endoleaks and SG migration). Based on a large literature study, in this contribution, 20 mechanical and geometri- cal parameters (e.g. SG drag force and SG fixation force) are defined to evaluate the quality of the in silico EVAR outcome. For a cohort of n=148 realizations of param- eterized vessel and SG geometries the in silico EVAR results are studied with respect to these mechanical and geometrical parameters. All degrees of SG oversizing in the range between 5% and 40% are investigated continuously by a computationally efficient parameter continuation approach. The in silico investigations have shown that the mechanical and geometrical param- eters are able to indicate candidates at high risk of postinterventional complications. Hence, this study provides the basis for the development of a simulation based metric to assess the potential success of EVAR based on engineering parameters.     «

The variety of stent-graft (SG) design variables (e.g. SG type and degree of SG oversizing) and the complexity of decision making whether a patient is suitable for endovascular aneurysm repair (EVAR) raise the need for the development of pre- dictive tools to assist clinicians in the preinterventional planning phase. Recently, some in silico EVAR methods have been developed to predict the deployed SG con- figuration. However, only few studies investigated how to assess the in silico EVAR outcome...     »