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

IEEE Trans Biomed Eng. 2017 May;64(5):1057-1066. doi: 10.1109/TBME.2016.2587362. Epub 2016 Jul 7.

Abstract

Objective: Validation of a numerical method to compute arterial deformations under the insertion of an "extra-siff" guidewire during Endovascular Repair of Abdominal Aortic Aneurysm.

Methods: We propose the validation of a previously developed simulation method. The model is calibrated using anatomical hypothesis and intraoperative observations. Simulation results are blindly evaluated against 3-D imaging data acquired during the surgical procedure on 28 patients, based on the predicted position of the intraoperative guidewire.

Results: Simulation was successfully conducted on the 28 patients. The mean position error given by the Modified Hausdorff Distance for the 28 cases was 3.8 ± 1.9 mm, which demonstrates very good results for most of the cases.

Conclusion: The work reported here shows that numerical simulation can predict some rather large variations in the vascular geometry due to tools insertion, for a wide variety of aorto-iliac morphologies. This is a new step toward clinically applicable mechanical simulation.

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

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aorta, Abdominal / physiopathology*
  • Aortic Aneurysm, Abdominal / physiopathology*
  • Aortic Aneurysm, Abdominal / surgery*
  • Computer Simulation
  • Elastic Modulus
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / methods
  • Fiducial Markers*
  • Finite Element Analysis
  • Humans
  • Models, Cardiovascular*
  • Patient-Specific Modeling
  • Prosthesis Implantation / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Single-Blind Method