Prediction of guidewire-induced aortic deformations during EVAR: a finite element and in vitro study

Introduction and aims: During an Endovascular Aneurysm Repair (EVAR) procedure a stiff guidewire is inserted from the iliac arteries. This induces significant deformations on vasculature, thus, affecting pre-operative planning, accuracy of image fusion. The aim present work to predict induced using finite element approach validated through experiments with patient-specific additive manufactured models. numerical herein developed could improve planning intra-operative navigation. Material methods: physical models used for in hybrid operating room, were segmentations Computed Tomography (CT) angiographies. analyses (FEA) performed LS-DYNA Explicit. material properties obtained by uniaxial tensile tests. experimental deformed configurations aorta compared those FEA. Three models, acquisitions, investigated work: A) without intraluminal thrombus (ILT), B) ILT, C) ILT calcifications. Results discussion: A good agreement was found between computational studies. average error final vitro vs. silico aortic configurations, i.e., when fully inserted, are equal 1.17, 1.22 1.40 mm, respectively, Models A, B C. increasing trend values Model C noticed both experimentally numerically. presented combination tracking technology endovascular devices may be obtain configuration vessels prior procedure, thus limiting radiation exposure contrast agent dose.