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Computational Fluid Dynamics Modeling of Redundant Stent-Graft Configurations in Endovascular Aneurysm Repair

[+] Author Affiliations
Leonard W. Tse

University of Toronto; Toronto General Hospital, Toronto, ON, Canada

Tina L. T. Shek, Aydin Nabovati, Cristina H. Amon

University of Toronto, Toronto, ON, Canada

Paper No. IMECE2010-39941, pp. 149-156; 8 pages
doi:10.1115/IMECE2010-39941
From:
  • ASME 2010 International Mechanical Engineering Congress and Exposition
  • Volume 2: Biomedical and Biotechnology Engineering
  • Vancouver, British Columbia, Canada, November 12–18, 2010
  • Conference Sponsors: ASME
  • ISBN: 978-0-7918-4426-7
  • Copyright © 2010 by ASME

abstract

An aneurysm is a bulge or localized dilation of an artery that can result in rupture, rapid blood loss, and death. Endovascular aneurysm repair (EVAR) is a minimally-invasive surgical technique that involves delivery of a stent-graft from within the blood vessels. The metallic stents anchor and support the graft (fabric tube), through which blood flow is contained and directed. This relieves the pressure on the weakened aneurysm wall. When the stent-graft is too long for a given patient, the redundant (extra) length adopts a convex configuration in the aneurysm. Based on clinical experience, we hypothesize that redundant stent-graft configurations increase the downward force acting on the device thereby increasing the risk of device dislodgement and failure. This work numerically studies both steady-state and physiologic pulsatile blood flow in redundant stent-graft configurations. Computational fluid dynamics simulations predicted peak downward displacement force for the zero-, moderate- and severe-redundancy configurations of 7.49, 7.65 and 8.04 N, respectively for steady-state flow; and 7.55, 7.70 and 8.31 N, respectively for physiologic pulsatile flow. These results suggest that redundant stent-graft configurations in EVAR do increase the downward force acting on the device, but the clinical consequence depends significantly on device-specific resistance to dislodgement.

Copyright © 2010 by ASME

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