3D Reconstruction and Manufacture of Real Abdominal Aortic Aneurysms: From CT Scan to Silicone Model

2008 ◽  
Vol 130 (3) ◽  
Author(s):  
B. J. Doyle ◽  
L. G. Morris ◽  
A. Callanan ◽  
P. Kelly ◽  
D. A. Vorp ◽  
...  

Abdominal aortic aneurysm (AAA) can be defined as a permanent and irreversible dilation of the infrarenal aorta. AAAs are often considered to be an aorta with a diameter 1.5 times the normal infrarenal aorta diameter. This paper describes a technique to manufacture realistic silicone AAA models for use with experimental studies. This paper is concerned with the reconstruction and manufacturing process of patient-specific AAAs. 3D reconstruction from computed tomography scan data allows the AAA to be created. Mould sets are then designed for these AAA models utilizing computer aided design∕computer aided manufacture techniques and combined with the injection-moulding method. Silicone rubber forms the basis of the resulting AAA model. Assessment of wall thickness and overall percentage difference from the final silicone model to that of the computer-generated model was performed. In these realistic AAA models, wall thickness was found to vary by an average of 9.21%. The percentage difference in wall thickness recorded can be attributed to the contraction of the casting wax and the expansion of the silicone during model manufacture. This method may be used in conjunction with wall stress studies using the photoelastic method or in fluid dynamic studies using a laser-Doppler anemometry. In conclusion, these patient-specific rubber AAA models can be used in experimental investigations, but should be assessed for wall thickness variability once manufactured.

2013 ◽  
Vol 136 (1) ◽  
Author(s):  
Sergio Ruiz de Galarreta ◽  
Aitor Cazón ◽  
Raúl Antón ◽  
Ender A. Finol

The goal of this work is to develop a framework for manufacturing nonuniform wall thickness replicas of abdominal aortic aneurysms (AAAs). The methodology was based on the use of computed tomography (CT) images for virtual modeling, additive manufacturing for the initial physical replica, and a vacuum casting process and range of polyurethane resins for the final rubberlike phantom. The average wall thickness of the resulting AAA phantom was compared with the average thickness of the corresponding patient-specific virtual model, obtaining an average dimensional mismatch of 180 μm (11.14%). The material characterization of the artery was determined from uniaxial tensile tests as various combinations of polyurethane resins were chosen due to their similarity with ex vivo AAA mechanical behavior in the physiological stress configuration. The proposed methodology yields AAA phantoms with nonuniform wall thickness using a fast and low-cost process. These replicas may be used in benchtop experiments to validate deformations obtained with numerical simulations using finite element analysis, or to validate optical methods developed to image ex vivo arterial deformations during pressure-inflation testing.


2020 ◽  
Vol 142 (6) ◽  
Author(s):  
Tejas Canchi ◽  
Sourav S. Patnaik ◽  
Hong N. Nguyen ◽  
E. Y. K. Ng ◽  
Sriram Narayanan ◽  
...  

Abstract In this work, we provide a quantitative assessment of the biomechanical and geometric features that characterize abdominal aortic aneurysm (AAA) models generated from 19 Asian and 19 Caucasian diameter-matched AAA patients. 3D patient-specific finite element models were generated and used to compute peak wall stress (PWS), 99th percentile wall stress (99th WS), and spatially averaged wall stress (AWS) for each AAA. In addition, 51 global geometric indices were calculated, which quantify the wall thickness, shape, and curvature of each AAA. The indices were correlated with 99th WS (the only biomechanical metric that exhibited significant association with geometric indices) using Spearman's correlation and subsequently with multivariate linear regression using backward elimination. For the Asian AAA group, 99th WS was highly correlated (R2 = 0.77) with three geometric indices, namely tortuosity, intraluminal thrombus volume, and area-averaged Gaussian curvature. Similarly, 99th WS in the Caucasian AAA group was highly correlated (R2 = 0.87) with six geometric indices, namely maximum AAA diameter, distal neck diameter, diameter–height ratio, minimum wall thickness variance, mode of the wall thickness variance, and area-averaged Gaussian curvature. Significant differences were found between the two groups for ten geometric indices; however, no differences were found for any of their respective biomechanical attributes. Assuming maximum AAA diameter as the most predictive metric for wall stress was found to be imprecise: 24% and 28% accuracy for the Asian and Caucasian groups, respectively. This investigation reveals that geometric indices other than maximum AAA diameter can serve as predictors of wall stress, and potentially for assessment of aneurysm rupture risk, in the Asian and Caucasian AAA populations.


Author(s):  
Avinash Ayyalasomayajula ◽  
Bruce R. Simon ◽  
Jonathan P. Vande Geest

Abdominal aortic aneurysm (AAA) is a progressive dilation of the infrarenal aorta and results in a significant alteration in local hemodynamic environment [1]. While an aneurysmal diameter of 5.5cm is typically classified as being of high risk, recent studies have demonstrated that maximum wall stress could be a better indicator of an AAA rupture than maximum diameter [2]. The wall stress is greatly influenced by the blood pressure, aneurysm diameter, shape, wall thickness and the presence of thrombus. The work done by Finol et al. suggested that hemodynamic pressure variations have an insignificant effect on AAA wall stress and that primarily the shape of the aneurysm determines the stress distribution. They noted that for peak wall stress studies the static pressure conditions would suffice as the in vivo conditions. Wang et al have developed an isotropic hyperelastic constitutive model for the intraluminal thrombus (ILT). Such models have been used to study the stress distributions in patient specific AAAs [3, 4].


2016 ◽  
Vol 38 (6) ◽  
pp. 526-537 ◽  
Author(s):  
Noel Conlisk ◽  
Arjan J. Geers ◽  
Olivia M.B. McBride ◽  
David E. Newby ◽  
Peter R. Hoskins

Author(s):  
Barry J. Doyle ◽  
Liam G. Morris ◽  
Anthony Callanan ◽  
Eamon Kavanagh ◽  
Pat Kelly ◽  
...  

Abdominal aortic aneurysm (AAA) is a local, permanent, irreversible dilation of the infrarenal section of the aorta that risks rupture until treated. AAA is defined as an infrarenal diameter 1.5 times the normal diameter. Currently, surgeons intervene when the aneurysm reaches a maximum diameter of 50mm [1]. 200,000 new cases are diagnosed each year in the US, with 500,000 new cases diagnosed worldwide [2]. This results in 15,000 deaths each year from AAA rupture in the US alone [3], with 8,000 deaths per year in the UK [4]. Literature supports the theory that small aneurysms may be as likely to rupture as larger aneurysms [5–7], and therefore, the need for a more reliable predictor of AAA rupture may have clinical importance.


2009 ◽  
Vol 131 (6) ◽  
Author(s):  
Giampaolo Martufi ◽  
Elena S. Di Martino ◽  
Cristina H. Amon ◽  
Satish C. Muluk ◽  
Ender A. Finol

The clinical assessment of abdominal aortic aneurysm (AAA) rupture risk is based on the quantification of AAA size by measuring its maximum diameter from computed tomography (CT) images and estimating the expansion rate of the aneurysm sac over time. Recent findings have shown that geometrical shape and size, as well as local wall thickness may be related to this risk; thus, reliable noninvasive image-based methods to evaluate AAA geometry have a potential to become valuable clinical tools. Utilizing existing CT data, the three-dimensional geometry of nine unruptured human AAAs was reconstructed and characterized quantitatively. We propose and evaluate a series of 1D size, 2D shape, 3D size, 3D shape, and second-order curvature-based indices to quantify AAA geometry, as well as the geometry of a size-matched idealized fusiform aneurysm and a patient-specific normal abdominal aorta used as controls. The wall thickness estimation algorithm, validated in our previous work, is tested against discrete point measurements taken from a cadaver tissue model, yielding an average relative difference in AAA wall thickness of 7.8%. It is unlikely that any one of the proposed geometrical indices alone would be a reliable index of rupture risk or a threshold for elective repair. Rather, the complete geometry and a positive correlation of a set of indices should be considered to assess the potential for rupture. With this quantitative parameter assessment, future research can be directed toward statistical analyses correlating the numerical values of these parameters with the risk of aneurysm rupture or intervention (surgical or endovascular). While this work does not provide direct insight into the possible clinical use of the geometric parameters, we believe it provides the foundation necessary for future efforts in that direction.


Author(s):  
Barry J. Doyle ◽  
Tim M. McGloughlin

Abdominal aortic aneurysm (AAA) is a permanent dilation of the infrarenal aorta and is defined as having a diameter 50% greater than the original diameter. If left untreated, an AAA will continue to expand until rupture. The maximum diameter is currently the primary indicator of rupture-risk with AAAs > 5.5 cm deemed a likely to rupture. There have, however, been many reports identifying the inadequacies of the maximum diameter criterion to accurately determine the threat of rupture. It is believed by many researchers that there is a need to review the decision of surgical intervention based solely on aneurysm diameter, and rather include other relevant risk factors. These additional risk factors could, for example, include, AAA wall stress, AAA expansion rate, degree of asymmetry, presence of intraluminal thrombus (ILT), and hypertension. The addition of these parameters may aid the surgical decision-making process. A previous report by our group identified the relationship between asymmetry and posterior wall stress in patient-specific cases [1,2] and as over 80% of ruptures occur on the posterior wall [3] this finding may have significant clinical relevance. In this previous report, the study group was limited to 15 cases and asymmetry was only measured in the anterior-posterior plane. This current paper furthers this previous work by increasing the cohort to 40 cases of electively repaired AAAs and also examines 8 cases of ruptured AAAs. The methodology has been improved to now measure asymmetry in all three dimensions (3D).


2017 ◽  
Vol 37 (suppl_1) ◽  
Author(s):  
Eric Shang ◽  
Grace Wang ◽  
Ronald Fairman ◽  
Benjamin Jackson

Objective: Women with abdominal aortic aneurysms (AAA) exhibit more rapid aneurysm growth and greater rupture risk at equivalent diameters relative to men. Evidence suggests that biomechanical peak wall stress (PWS) derived from finite element analysis of AAAs is a superior predictor of rupture compared to maximum transverse diameter (MTD). This study aimed to investigate differences in the calculated PWS of AAAs between men and women. Method: Men (n=35) and women (n=35) with infrarenal AAAs with 45-55mm MTD undergoing CTA were identified. Customized image processing algorithms extracted patient-specific AAA geometries from raw DICOM images. The resulting aortic reconstructions incorporated patient-specific and regionally resolved aortic wall thickness, intraluminal thrombus, and wall calcifications. Aortic models were loaded with 120mmHg blood pressure using commercially available FEA solvers. Results: Peak wall stress was found to be significantly higher in women (299±51 vs 257±53 kPA, P=0.001, see Figure). Neither MTD (50.5±3.1 vs 49.8±2.9 mm, P=0.34), mean aortic wall thickness (2.38±0.52 vs 2.34±0.50 mm, P=0.69), nor wall thickness at location of PWS (2.36±0.60 vs 2.20±0.46 mm, P=0.20) varied by sex. While there were no sex-associated differences in aneurysm volume (86.6±27.0 vs 94.8±25.5 cm 3 , P=0.76) or intraluminal thrombus volume (14.2±11.7 vs 16.3±13.4 mm, P=0.33), women’s AAAs had significantly increased maximum Gaussian curvature (0.032±0.011 vs 0.025±0.015 mm -2 , P=0.03). Conclusion: Comparably sized AAAs in women were shown to have significantly higher peak wall stress. Maximum gaussian curvature, a measure of aneurysm morphology, was significantly different between the two groups. These results suggest that men and women possess distinct aneurysm geometries, and that PWS-derived rupture risk prediction may provide a more reliable estimator of rupture risk in all patients.


2012 ◽  
Vol 9 (74) ◽  
pp. 2047-2058 ◽  
Author(s):  
J. S. Wilson ◽  
S. Baek ◽  
J. D. Humphrey

Complementary advances in medical imaging, vascular biology and biomechanics promise to enable computational modelling of abdominal aortic aneurysms to play increasingly important roles in clinical decision processes. Using a finite-element-based growth and remodelling model of evolving aneurysm geometry and material properties, we show that regional variations in material anisotropy, stiffness and wall thickness should be expected to arise naturally and thus should be included in analyses of aneurysmal enlargement or wall stress. In addition, by initiating the model from best-fit material parameters estimated for non-aneurysmal aortas from different subjects, we show that the initial state of the aorta may influence strongly the subsequent rate of enlargement, wall thickness, mechanical behaviour and thus stress in the lesion. We submit, therefore, that clinically reliable modelling of the enlargement and overall rupture-potential of aneurysms may require both a better understanding of the mechanobiological processes that govern the evolution of these lesions and new methods of determining the patient-specific state of the pre-aneurysmal aorta (or correlation to currently unaffected portions thereof) through knowledge of demographics, comorbidities, lifestyle, genetics and future non-invasive or minimally invasive tests.


Sign in / Sign up

Export Citation Format

Share Document