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Tasso P, Raptis A, Matsagkas M, et al. Abdominal aortic aneurysm endovascular repair: profiling post-implantation morphometry and hemodynamics with image-based computational fluid dynamics. J Biomech Eng. 2018;doi: 10.1115/1.4040337.
Tasso, P., Raptis, A., Matsagkas, M., Lodi Rizzini, M., Gallo, D., Xenos, M., & Morbiducci, U. (2018). Abdominal aortic aneurysm endovascular repair: profiling post-implantation morphometry and hemodynamics with image-based computational fluid dynamics. Journal of biomechanical engineering, . https://doi.org/10.1115/1.4040337
Tasso, Paola, et al. "Abdominal aortic aneurysm endovascular repair: profiling post-implantation morphometry and hemodynamics with image-based computational fluid dynamics." Journal of biomechanical engineering vol. (2018). doi: https://doi.org/10.1115/1.4040337
Tasso P, Raptis A, Matsagkas M, Lodi Rizzini M, Gallo D, Xenos M, Morbiducci U. Abdominal aortic aneurysm endovascular repair: profiling post-implantation morphometry and hemodynamics with image-based computational fluid dynamics. J Biomech Eng. 2018 May 23; doi: 10.1115/1.4040337. Epub 2018 May 23. PMID: 30029263.
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J Biomech Eng. 2018 May 23; doi: 10.1115/1.4040337. Epub 2018 May 23.

Abdominal aortic aneurysm endovascular repair: profiling post-implantation morphometry and hemodynamics with image-based computational fluid dynamics.

Journal of biomechanical engineering

Paola Tasso, Anastasios Raptis, Miltiadis Matsagkas, Maurizio Lodi Rizzini, Diego Gallo, Michalis Xenos, Umberto Morbiducci

Affiliations

  1. Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Torino 10129, Italy.
  2. Laboratory for Vascular Simulations, Institute of Vascular Diseases, Ioannina 45500, Greece.
  3. Department of Vascular Surgery, Faculty of Medicine, University of Thessaly, Larissa 41334, Greece.
  4. Department of Mathematics, University of Ioannina, Ioannina 45500, Greece.

PMID: 30029263 DOI: 10.1115/1.4040337

Abstract

Endovascular aneurysm repair (EVAR) has disseminated rapidly as an alternative to open surgical repair for the treatment of abdominal aortic aneurysms (AAAs), because of its reduced invasiveness, low mortality and morbidity rate. The effectiveness of the endovascular devices used in EVAR is always at question as postoperative adverse events can lead to re-intervention or to a possible fatal scenario for the circulatory system. Motivated by the assessment of the risks related to thrombus formation, here the impact of two different commercial endovascular grafts on local hemodynamics is explored through 20 image-based computational hemodynamic models of EVAR-treated patients (N=10 per each endograft model). Hemodynamic features, susceptible to promote thrombus formation, such as flow separation and recirculation, are quantitatively assessed and compared with the local hemodynamics established in image-based infrarenal abdominal aortic models of healthy subjects (N=10). The hemodynamic analysis is complemented by a geometrical characterization of the EVAR-induced reshaping of the infrarenal abdominal aortic vascular region. The findings of this study indicate that: (1) the clinically observed propensity to thrombus formation in devices used in EVAR strategies can be explained in terms of local hemodynamics by means of image-based computational hemodynamics approach; (2) reportedly pro-thrombotic hemodynamic structures are strongly correlated with the geometry of the aortoiliac tract postoperatively. In perspective, our study suggests that future clinical follow up studies could include a geometric analysis of the region of the implant, monitoring shape variations that can lead to hemodynamic disturbances of clinical significance.

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