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research-article

Hemodynamic profile of two aortic endografts accounting for their post-implantation position

[+] Author and Article Information
Anastasios Raptis

Cardiovascular Surgery Department, Sector of Surgery, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece; Institute of Vascular Diseases, Laboratory for Vascular Simulations, Ioannina, Greece
anraptis@cc.uoi.gr
raptistasos@gmail.com

Michalis Xenos

Department of Mathematics, University of Ioannina, Ioannina, Greece; Institute of Vascular Diseases, Laboratory for Vascular Simulations, Ioannina, Greece
mxenos@cc.uoi.gr

Efstratios Georgakarakos

Department of Vascular Surgery, “Democritus” Medical School, University Hospital of Alexandroupolis, Greece
efstratiosgeorg@gmail.com

George Kouvelos

Department of Vascular Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece
geokouv@gmail.com

Athanasios Giannoukas

Department of Vascular Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece; Institute of Vascular Diseases, Laboratory for Vascular Simulations, Ioannina, Greece
giannouk@med.uth.gr

Miltiadis Matsagkas

Department of Vascular Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece; Institute of Vascular Diseases, Laboratory for Vascular Simulations, Ioannina, Greece
mimats@med.uth.gr
mmats@otenet.gr

1Corresponding author.

ASME doi:10.1115/1.4035687 History: Received June 24, 2016; Revised December 22, 2016

Abstract

Endovascular aneurysm repair (EVAR) is a clinically effective technique for treating anatomically eligible abdominal aortic aneurysms (AAAs), involving the deployment of an endograft (EG) that is designed to prevent blood leakage in the aneurysmal sac. While most EGs have equivalent operating principles, the hemodynamic environment established by different EGs is not necessarily the same. So, to unveil the post-EVAR hemodynamic properties, we need an EG-specific computational approach that currently lacks from the literature. Endurant and Excluder are two EGs with similar pre-installation designs. We assumed that the flow conditions in the particular EGs do not vary significantly. The hypothesis was tested combining image reconstructions, computational fluid dynamics (CFD) and statistics, taking into account the post-implantation position of the EGs. Ten patients with Endurant EGs and ten patients with Excluder EGs were included in the study. The two groups were matched with respect to the preoperative morphological characteristics of the AAAs. The EG models derived from image reconstructions of postoperative computed tomography scans. Wall shear stress (WSS), displacement force, velocity, and helicity were calculated in regions of interest within the EG structures, i.e. the main body, the upper and the lower part of the limbs. Excluder generated higher WSS compared to Endurant, especially on the lower part of the limbs (p=0.001)...

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