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Stent graft visualization and planning tool for endovascular surgery using finite element analysis

Stent-Graft Visualisierungs- und Planungswerkzeug auf Basis der Finite-Elemente-Analyse für die endovaskuläre Operation
: Sachsen, Sandra von; Senf, Björn; Burgert, Oliver; Meixensberger, Jürgen; Florek, Hans-Joachim; Mohr, Friedrich Wilhelm; Etz, Christian Daniel


International journal of computer assisted radiology and surgery 9 (2014), No.4, pp.617-633
ISSN: 1861-6410
ISSN: 1861-6429
Journal Article
Fraunhofer IWU ()
medical postprocessor; simulation-based treatment planning; biomedical visualization; implant planning; finite element analysis; stent graft; EVAR

A new approach to optimize stent graft selection for endovascular aortic repair is the use of finite element analysis. Once the finite element model is created and solved, a software module is needed to view the simulation results in the clinical work environment. A new tool for interpretation of simulation results, named Medical Postprocessor, that enables comparison of different stent graft configurations and products was designed, implemented and tested. Aortic endovascular stent graft ring forces and sealing states in the vessel landing zone of three different configurations were provided in a surgical planning software using the Medical Imaging Interaction Tool Kit (MITK) software system. For data interpretation, software modules for 2D and 3D presentations were implemented. Ten surgeons evaluated the software features of the visualization system, termed Medical Postprocessor. These surgeons performed usability tests and answered questionnaires based on their experience with the system. The Medical Postprocessor visualization system enabled vascular surgeons to determine the configuration with the highest overall fixation force in 16 +-6 seconds, best proximal sealing in 56 +-24 seconds and highest proximal fixation force in 38 +-12 seconds. The majority considered the multiformat data provided helpful, and found the Medical Postprocessor to be an efficient decision support system for stent graft selection. The evaluation of the user interface results in an ISONORM-conform user interface (113.5 points). The Medical Postprocessor visualization software tool for analyzing stent graft properties was evaluated by vascular surgeons. The results show that the software can assist the interpretation of simulation results to optimize stent graft selection and sizing.