An Integrated Software System for Preoperatively Evaluating Aorto-femoral Reconstruction Procedures

INTRODUCTION Traditionally, engineers have constructed and tested physical prototypes to create new devices and improve on existing designs. The current paradigm in planning treatment for patients with vascular disease is similar to traditional prototyping found in engineering. Specifically, a surgeon will select a procedure for a particular patient based on past experience for patients with a similar state of disease. The experience gained from this patient will be selectively used when treating the next patient with similar symptoms. In this fashion, the surgeon is using a “build and test” approach where the design of a particular procedure is iteratively improved. In this work, a surgical planning system was developed enabling a vascular surgeon to create and test alternative operative plans prior to surgery for a given patient. Hemodynamic (i.e. blood flow) simulations were performed for the operative plans for two aortofemoral bypass (AFB) patients and compared with actual postoperative data. The information that can be obtained from hemodynamic simulation (e.g. wall shear stress) may be clinically relevant to future vascular surgeons planning surgical interventions. The work presented differs from previously published related work [1-3] in that geometric models for actual aorto-femoral reconstruction patients were created preoperatively in a clinically relevant time frame. In addition, prior to this work no system existed that enabled a surgeon to create surgical plans to be evaluated prior to surgery.