A computational study of the magnitude and direction of migration forces in patient-specific abdominal aortic aneurysm stent-grafts

D. S. Molony, E. G. Kavanagh, P. Madhavan, M. T. Walsh, T. M. McGloughlin

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Endovascular aneurysm repair for abdominal aortic aneurysm (AAA) is now a widely adopted treatment. Several complications remain to be fully resolved and perhaps the most significant of these is graft migration. Haemodynamic drag forces are believed to be partly responsible for migration of the device. The objective of this work was to investigate the drag forces in patient-specific AAA stent-grafts. Methods: CT scan data was obtained from 10 post-operative AAA patients treated with stentgrafts. 3D models of the aneurysm, intraluminal thrombus and stent-graft were created. The drag forces were determined by fluid-structure interaction simulations. A worst case scenario was investigated by altering the aortic waveforms. Results: The median resultant drag force was 5.46 N (range: 2.53e10.84). An increase in proximal neck angulation resulted in an increase in the resultant drag force (p = 0.009). The primary force vector was found to act in an anterior caudal direction for most patients. The worst case scenario simulation resulted in a greatest drag force of 16 N. Conclusions: Numerical methods can be used to determine patient-specific drag forces which may help determine the likelihood of stent-graft migration. Anterioreposterior neck angulation appears to be the greatest determinant of drag force magnitude. Graft dislodgement may occur anteriorally as well as caudally.

Original languageEnglish
Pages (from-to)332-339
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume40
Issue number3
DOIs
Publication statusPublished - Sep 2010

Keywords

  • Abdominal aortic aneurysm
  • Drag forces
  • EVAR
  • Graft migration

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