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dc.creatorTasso P., Raptis A., Matsagkas M., Rizzini M.L., Gallo D., Xenos M., Morbiducci U.en
dc.description.abstractEndovascular aneurysm repair (EVAR) has disseminated rapidly as an alternative to open surgical repair for the treatment of abdominal aortic aneurysms (AAAs), because of its reduced invasiveness, low mortality, and morbidity rate. The effectiveness of the endovascular devices used in EVAR is always at question as postoperative adverse events can lead to re-intervention or to a possible fatal scenario for the circulatory system. Motivated by the assessment of the risks related to thrombus formation, here the impact of two different commercial endovascular grafts on local hemodynamics is explored through 20 image-based computational hemodynamic models of EVAR-treated patients (N = 10 per each endograft model). Hemodynamic features, susceptible to promote thrombus formation, such as flow separation and recirculation, are quantitatively assessed and compared with the local hemodynamics established in image-based infrarenal abdominal aortic models of healthy subjects (N = 10). Moreover, the durability of endovascular devices is investigated analyzing the displacement forces (DFs) acting on them. The hemodynamic analysis is complemented by a geometrical characterization of the EVAR-induced reshaping of the infrarenal abdominal aortic vascular region. The findings of this study indicate that (1) the clinically observed propensity to thrombus formation in devices used in EVAR strategies can be explained in terms of local hemodynamics by means of image-based computational hemodynamics approach; (2) reportedly prothrombotic hemodynamic structures are strongly associated with the geometry of the aortoiliac tract postoperatively; and (3) DFs are associated with cross-sectional area of the aortoiliac tract postoperatively. In perspective, our study suggests that future clinical followup studies could include a geometric analysis of the region of the implant, monitoring shape variations that can lead to hemodynamic disturbances of clinical significance. Copyright © 2018 by ASME.en
dc.sourceJournal of Biomechanical Engineeringen
dc.subjectBlood vesselsen
dc.subjectComputational fluid dynamicsen
dc.subjectComputational geometryen
dc.subjectFlow separationen
dc.subjectPatient treatmenten
dc.subjectRisk assessmenten
dc.subjectAbdominal aortic aneurysmsen
dc.subjectCirculatory systemsen
dc.subjectCross sectional areaen
dc.subjectEndovascular devicesen
dc.subjectEndovascular repairen
dc.subjectGeometric analysisen
dc.subjectImage based computational hemodynamicsen
dc.subjectThrombus formationen
dc.subjectabdominal aortic aneurysmen
dc.subjectblood clottingen
dc.subjectclinical featureen
dc.subjectcomputational fluid dynamicsen
dc.subjectendovascular aneurysm repairen
dc.subjectfollow upen
dc.subjectnormal humanen
dc.subjectpostoperative perioden
dc.subjectAmerican Society of Mechanical Engineers (ASME)en
dc.titleAbdominal Aortic Aneurysm Endovascular Repair: Profiling Postimplantation Morphometry and Hemodynamics with Image-Based Computational Fluid Dynamicsen

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