A Preliminary Study of Fast Virtual Stent-Graft Deployment: Application to Stanford Type B Aortic Dissection

Abstract

Aortic dissection is the result of blood intruding into the layers of the aortic wall creating a duplicate channel along the aortic course. This considerably changes aortic morphology and thereby alters blood flow, inducing severe pathological conditions. Endovascular stent-graft placement has become an accepted treatment option for complicated Stanford type B aortic dissection. Stent-graft deployment aims to cover the primary entry, preventing most of the inflow to the false lumen, thereby promoting false lumen thrombosis and true lumen expansion. In recent years the application of this treatment has increased continuously. However, a fast and reasonable prediction for the released stent-graft and the resulting aortic remodelling prior to intervention is still lacking. In this paper, we propose a preliminary study on the fast virtual stent-graft deployment algorithm based on contact mechanics, spring analogy and deformable meshes. By virtually releasing a stent-graft in a patient-specific model of an aortic dissection type Stanford B, we simulate the interaction between the expanding stent-graft and the vessel wall (with low computational cost), and estimate the post-interventional configuration of the true lumen. This preliminary study can be finished within minutes and the results present good consistency with the post-interventional computed tomography angiography. It therefore confirms the feasibility and rationality of this algorithm, encouraging further research on this topic, which may provide more accurate results and could assist in medical decision-making.