Last updated on September 2018

Validation of Fenestrations Positioning by Numerical Simulation


Brief description of study

Fenestrated endovascular repair (FEVAR) is nowadays a recognized option to treat juxtarenal, pararenal or suprarenal abdominal aortic aneurysms in patients at high risk for conventional repair. The technique consists in deploying a custom-made stent-graft (SG) inside the patient aorta. Part of the customization involves cauterizing a hole in SG fabric and reinforcing it with a Nitinol stent ring, thereby creating a fenestration for each corresponding collateral artery. For this reason, preoperative planning is crucial to determine adequate positions of fenestrations, in order to obtain perfect alignment with the collateral arteries of the patient. Inadequate positioning may result in failure to catheterize a collateral artery and subsequent organ damage, increased catheterizing time, increased irradiation dose, endoleaks The current process of fenestrations positioning for fenestrated anacondaTM SG involves: (i) anatomical measurements on patient preoperative CT-scan by case planners using dedicated sizing software; (ii) designing an initial custom device scheme with its positioned fenestrations, created by engineers with CAD software using the above cited measurements and (iii) validation of fenestrations position by in vitro testing using a SG prototype deployed inside a transparent anatomy model (3D-printed model of patient aorta and collateral arteries). The main limitations of this process are the costs and long SG delivery time.

Detailed Study Description

The current process of fenestrations positioning for fenestrated anacondaTM SG involves: (i) anatomical measurements on patient preoperative CT-scan by case planners using dedicated sizing software; (ii) designing an initial custom device scheme with its positioned fenestrations, created by engineers with CAD software using the above cited measurements and (iii) validation of fenestrations position by in vitro testing using a SG prototype deployed inside a transparent anatomy model (3D-printed model of patient aorta and collateral arteries). The main limitations of this process are the costs and long SG delivery time.

The goal of this study is to compare fenestrations positioning obtained by two different processes, the actual one at Vascutek and the one by numerical simulation performed by Predisurge company.

Clinical Study Identifier: NCT03469245

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Assadian, MD

Wilhelminen hospital
Vienna, Austria
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Dominique Midy, PhD

CHU Bordeaux
Bordeaux, France
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Frisch, PhD

H pitaux priv s de Metz
Metz, France
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Bertrand Chavent, MD

Chu Saint-Etienne
Saint-Étienne, France
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Greiner, PhD

University Hospital, Campus Benjamin Franklin
Berlin, Germany
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Reijnen, MD

Rijnstate Hospital
Arnhem, Netherlands
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Vanherwaarden, MD

University Hospital Utrecht
Utrecht, Netherlands
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Peter Bungay, MD

Derby Hospital
Derby, United Kingdom
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