Patient-specific simulation of stent-graft deployment in type B aortic dissection: model development and validation
File(s)
Published Version
Author(s)
Type
Journal Article
Abstract
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 SG
Date Issued
2021-08-24
Date Acceptance
2021-08-11
Citation
Biomechanics and Modeling in Mechanobiology, 2021, 20, pp.2247-2258
ISSN
1617-7940
Publisher
Springer
Start Page
2247
End Page
2258
Journal / Book Title
Biomechanics and Modeling in Mechanobiology
Volume
20
Copyright Statement
© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Sponsor
The Royal Society
Identifier
https://link.springer.com/article/10.1007%2Fs10237-021-01504-x
Grant Number
IE161052
Subjects
Science & Technology
Life Sciences & Biomedicine
Technology
Biophysics
Engineering, Biomedical
Engineering
Finite element analysis
TEVAR
Type B aortic dissection
Virtual stent-graft deployment
ENDOVASCULAR REPAIR
ENTRY
DIAGNOSIS
Finite element analysis
TEVAR
Type B aortic dissection
Virtual stent-graft deployment
0903 Biomedical Engineering
0913 Mechanical Engineering
Biomedical Engineering
Publication Status
Published
Date Publish Online
2021-08-24