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Finite element simulation of the insertion of guidewires during an EVAR procedure: example of a complex patient case, a first step toward patient-specific parameterized models
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Edité par CCSD ; John Wiley and Sons -
International audience. Deformations of the vascular structure due to the insertion of tools during endovascular treatment of aneurysms of the abdominal aorta, unless properly anticipated during the preoperative planning phase, may bethe source of intraoperative or postoperative complications. We propose here an explicit finite element simulation method which enables one to predict such deformations. This method is based on a mechanical model of the vascular structure which takes into account the nonlinear behavior of the arterial wall, the prestressingeffect induced by the blood pressure and the mechanical support of the surrounding organs and structures. Ananalysis of the model sensitivity to the parameters used to represent this environment is done. This allowsdetermining the parameters that have the largest influence on the quality of the prediction and also providesrealistic values for each of them as no experimental data are available in the literature. Moreover, for the firsttime, the results are compared with 3D intraoperative data. This is done for a patient-specific case with a complex anatomy in order to assess the feasibility of the method. Finally, the predictive capability of the simulation is evaluated on a group of nine patients. The error between the final simulated and intraoperativelymeasured tool positions was 2.1 mm after the calibration phase on one patient. It results in a 4.6 ± 2.5 mmin average error for the blind evaluation on nine patients.
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