Virtual stent-graft planning: numerical simulation of the endovascular repair of abdominal aortic aneurysms

我们正在开发一种软件，以模拟医疗设备如何用于腹主动脉瘤(AAA)的腔内修复，腹主动脉瘤的特征是主动脉在肾动脉下方膨胀。其目的是预测通过导管引入的被称为支架移植物(SG)的血管假体的部署，作为一种比传统的“开放”手术侵入性更小的选择，在传统的“开放”手术中，患者的腹部被打开，假体直接缝合在主动脉中。在任何情况下，这种血管假体将动脉瘤囊排除在血压之外，从而限制了破裂的风险。 事实上，在加拿大，循环系统疾病是仅次于癌症的第二大死因。每年49000人死亡，或者说每11分钟就有一人死亡。(加拿大统计局，2012年)。AAA是这些疾病之一，相关的破裂导致50%的病例死亡。然而，血管内修复仍然存在一些潜在的并发症，如内漏、扭结和移位。因此，仔细的干预计划是至关重要的，这就是为什么我们正在开发一种模拟工具，以选择适合特定患者的最佳假体，并将并发症和再次干预的风险降至最低，特别是在复杂情况下。最终，这项工作也可能成为外科医生和介入放射科医生的培训平台。伦理委员会将参与保护该项目中使用的任何患者数据。

We are developing a software to simulate how a medical device is used in the endovascular repair of abdominal aortic aneurysms (AAA) which are characterized by a ballooning of the aorta below the renal arteries. The objective is to predict the deployment of vascular prostheses called stent-grafts (SG) introduced with catheters, as a less invasive alternative than the classic "open" surgery in which the patient's abdomen is opened and the prosthesis stitched directly in the aorta. In any case, such vascular prostheses exclude the aneurismal sac from blood pressure, thus limiting the rupture risk. As a matter of fact, in Canada circulatory system diseases are the second cause of death after cancer with approx. 49000 deaths per year, or one every 11 min. (Statistics Canada, 2012). AAA is among those diseases and the associated rupture leads to death in 50% of the cases. However, the endovascular repair still implies some potential complications such as endoleaks, kinking and migration of the deployed SG. Therefore, a careful intervention planning is essential, that's why we are developing a simulating tool to select the best prostheses for a given patient and minimize the risk of complications and re-interventions, especially in complex cases. Eventually, this work could also become a training platform for surgeons and interventional radiologists. An ethic committee will be involved to protect any patient data used in this project.