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

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

 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 Medical Postprocessor. These surgeons performed usability tests and answered questionnaires based on their experience with the system.

Results

The Medical Postprocessor visualization system enabled vascular surgeons to determine the configuration with the highest overall fixation force in \(16 \pm 6\) s, best proximal sealing in \(56 \pm 24\) s and highest proximal fixation force in \(38\pm 12\) s. 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).

Conclusion

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 configuration and sizing.

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Acknowledgments

This work was sponsored by funds of the European Regional Development Fund (ERDF) and the state of Saxony within the framework of measures supporting the technology sector.

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Conflict of interest

Sandra von Sachsen, Björn Senf, Oliver Burgert, Jürgen Meixensberger, Hans-Joachim Florek, Friedrich Wilhelm Mohr and Christian Dirk Etz declare that they have no conflict of interest.

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Authors and Affiliations

  1. Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany

    S. von Sachsen, J. Meixensberger & F. W. Mohr

  2. Fraunhofer Institute for Machine Tools and Forming Technology IWU, Dresden, Germany

    B. Senf

  3. Department of Informatic, Reutlingen University, Reutlingen, Germany

    O. Burgert

  4. Weisseritztalkliniken GmbH Freital, Freital, Germany

    H. J. Florek

  5. Mount Sinai Hospital, New York, NY, USA

    C. D. Etz

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  1. S. von Sachsen
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  2. B. Senf
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  3. O. Burgert
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  4. J. Meixensberger
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  5. H. J. Florek
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  6. F. W. Mohr
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  7. C. D. Etz
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Correspondence to S. von Sachsen.

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von Sachsen, S., Senf, B., Burgert, O. et al. Stent graft visualization and planning tool for endovascular surgery using finite element analysis. Int J CARS 9, 617–633 (2014). https://doi.org/10.1007/s11548-013-0943-2

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  • DOI: https://doi.org/10.1007/s11548-013-0943-2

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