Simulation of bifurcated stent grafts to treat abdominal aortic aneurysms (AAA)

TL;DR

This paper presents a novel method for visualizing and simulating bifurcated stent grafts in CT data to assist in planning minimally invasive AAA treatments, ensuring precise fitting and dimension measurement.

Contribution

The paper introduces a new simulation technique combining segmentation, skeletonization, and ACM fitting to improve stent graft selection and fitting accuracy.

Findings

Supports better therapy planning for AAA

Enables precise measurement of vessel dimensions

Simulates stent fitting to verify suitability

Abstract

In this paper a method is introduced, to visualize bifurcated stent grafts in CT-Data. The aim is to improve therapy planning for minimal invasive treatment of abdominal aortic aneurysms (AAA). Due to precise measurement of the abdominal aortic aneurysm and exact simulation of the bifurcated stent graft, physicians are supported in choosing a suitable stent prior to an intervention. The presented method can be used to measure the dimensions of the abdominal aortic aneurysm as well as simulate a bifurcated stent graft. Both of these procedures are based on a preceding segmentation and skeletonization of the aortic, right and left iliac. Using these centerlines (aortic, right and left iliac) a bifurcated initial stent is constructed. Through the implementation of an ACM method the initial stent is fit iteratively to the vessel walls - due to the influence of external forces (distance- as well as balloonforce). Following the fitting process, the crucial values for choosing a bifurcated stent graft are measured, e.g. aortic diameter, right and left common iliac diameter, minimum diameter of distal neck. The selected stent is then simulated to the CT-Data - starting with the initial stent. It hereby becomes apparent if the dimensions of the bifurcated stent graft are exact, i.e. the fitting to the arteries was done properly and no ostium was covered.