Patient-Specific Finite-Element Simulation of the Insertion of Guidewire During an EVAR Procedure: Guidewire Position Prediction Validation on 28 Cases

Gindre, Juliette; Bel-Brunon, Aline; Rochette, Michel; Lucas, Antoine; Kaladji, Adrien; Haigron, Pascal; Combescure, Alain

doi:10.1109/tbme.2016.2587362

Cited by 39 publications

(44 citation statements)

References 31 publications

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“…As long as registration is based on bony structures (hence with rigid transformations), there will be a mismatch with arterial structures which by nature are soft and deformable, which therefore calls for approaches based on elastic registration (27), for example, or digital simulation approaches that predict deformations using a biomechanical model. We have already published several studies on this simulation approach (10,11), which is integrated into the…”

Section: Limitationsmentioning

confidence: 99%

Fusion Imaging for EVAR with Mobile C-arm

Kaladji

Villena

Pascot

et al. 2019

Annals of Vascular Surgery

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Section: Limitationsmentioning

confidence: 99%

Fusion Imaging for EVAR with Mobile C-arm

Kaladji

Villena

Pascot

et al. 2019

Annals of Vascular Surgery

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“…In the future, the model of the anatomy will be updated to compensate for breathing and cardiac cycle movements by using predictive respiratory motion model and/ or intraoperative data, such as 3D ultrasound . Furthermore patient‐specific finite element analysis could be used to predict arterial deformations due to the interaction with the endovascular instrumentation . Finally, future research will be devoted to test the proposed EM guided laser fenestration tool in animal model, with a careful evaluation of: the shape and the edges of the laser‐generated holes in the endograft fabric, the entity of any attenuation effect by presence of the fabric material, and the extent of any possibly damage to the aortic wall.…”

Section: Resultsmentioning

confidence: 99%

In situ diode laser fenestration: An ex‐vivo evaluation of irradiation effects on human aortic tissue

Piazza

Micheletti

Condino

et al. 2019

Journal of Biophotonics

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The in situ laser fenestration is an interesting option for the endovascular treatment of short‐necked aneurysms with an intraoperative modification of a standard endograft. According to literature evidence, diode laser emitting in the near‐infrared wavelength (810 nm) can be successfully used to fenestrate the endograft fabric. This paper describes a three‐dimensional navigation system for the accurate targeting of the fenestration site, then reports results of an ex vivo study to assess whether the laser operative conditions, which ensure the fabric fenestration, are harmless for the biological tissue surrounding the endoprosthesis. Two hundred twenty‐five samples of human aorta, including healthy specimens and abdominal aortic aneurysm samples, were irradiated ex vivo using a 810 nm diode laser. Energy and pulse duration were varied. Irradiated tissues were fixed in formaldehyde, sectioned and subjected to histological examination. Only 7.5% of the irradiated samples exhibited a thermal damage, which was always confined to the contact point between the laser fiber tip and the aortic wall. These experiments suggest that the diode laser can be safely used for the proposed surgical application.

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“…Особое внимание среди литературных данных следует уделить работам P. Vy [18] и Gindre J. [19], оценивающим поведение проводниковых катетеров в численном эксперименте. Авторы показывают, что значения силы, достаточной для движения проводника составляют до 0.2 Н; в настоящем исследовании -подключение к проводнику транскатетерной системы доставки при моделирование процедуры TAVI вызывает дополнительный значительный рост сил -до 7.8 Н. Несмотря на столь значимые различия, нельзя пренебрегать влиянием проводника на результат вмешательства как одного из «источников» контактных сил, вызывающих изменение напряжения в стенке корня аорты, а также элемента, формирующего реальную траекторию движения системы доставки.…”

Section: г) процедура имплантацииunclassified

“…Наиболее перспективными с точки зрения прогностической ценности являются недавние работы, посвященные моделированию введения проводника, в том числе, при воссоздании начальных этапов TAVI [18,19]. Такой подход позволяет последовательно, начиная с первых стадий имплантации, учесть особенности напряженно-деформированного состояния всех элементов процедуры, их взаимодействие и взаимное влияние друг на друга, что, предположительно, должно положительно сказаться на качестве моделирования TAVI.…”

Section: Introductionunclassified

“…Такой подход позволяет последовательно, начиная с первых стадий имплантации, учесть особенности напряженно-деформированного состояния всех элементов процедуры, их взаимодействие и взаимное влияние друг на друга, что, предположительно, должно положительно сказаться на качестве моделирования TAVI. Данная работа посвящена развитию идей, предложенных в описанных исследованиях [18][19][20], с включением в систему взаимодействия тел непосредственно модели протеза клапана сердца и катетера системы доставки с последующей валидацией вариантов моделирования на основе клинических данных.…”

Section: Introductionunclassified

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Simulation of Transcatheter Aortic Valve Implantation Procedure

Klyshnikov¹,

Ganyukov²,

Batranin³

et al. 2019

Math.Biol.Bioinf.

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The study is devoted to numerical modeling of transcatheter aortic valve implantation (TAVI) from the position of prognostic value in comparison with clinical data. The finite element method implemented in the Abaqus/CAE software and the reconstruction of three-dimensional models based on the computer microtomography of the CoreValve bioprosthesis of a size of 29 mm and the patient-specific data of functional studies (multispiral tomography) were used in the work. The study included three variations in the modeling of the aortic valve prosthesis procedure, which determine the level of detalization of the numerical experiment. All stages of the TAVI process were reproduced: the crimp of the prosthesis, the movement of the delivery system, the interaction of the guide - guidewire with the elements of the “prosthesis-root” of the aorta system, implantation itself. In silico experiment demonstrated significant quantitative and qualitative agreement with the data of intraoperative fluorography and computed tomography after the TAVI procedure. It is shown that the inclusion of additional elements – the guidewire and catheter of the delivery system into the “aortic root” has a positive effect on the convergence of the data with the clinical results. The analysis of the stress-strain state of the elements interacting in the experiment demonstrated a significant contribution to the analyzed parameters of the prosthetic motion stage along the guidewire as part of the delivery system catheter. Nevertheless, a comparison with the results of the clinical evaluation of the TAVI procedure revealed a number of differences in the response of the model of the bioprosthesis at the later stages of modeling, which requires further researches of a level of detalization. The approach is extremely promising both for practitioners and for research work of prosthetic designers, it can be applied in further R&D tasks.

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Patient-Specific Finite-Element Simulation of the Insertion of Guidewire During an EVAR Procedure: Guidewire Position Prediction Validation on 28 Cases

Abstract: Validation on 3-D intraoperative data on a large number of cases-robustness on adverse anatomies.

Cited by 39 publications

References 31 publications

Fusion Imaging for EVAR with Mobile C-arm

Fusion Imaging for EVAR with Mobile C-arm

In situ diode laser fenestration: An ex‐vivo evaluation of irradiation effects on human aortic tissue

Simulation of Transcatheter Aortic Valve Implantation Procedure

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