New model to study endovascular aneuryism sealing

Researchers at the University of Liverpool have developed a mathematical model that has the potential to improve the performance of endovascular aneurysm sealing (EVAS), which is an innovative procedure to treat abdominal aortic aneurysms (AAA).

AAA is a swelling of part of the aorta inside the abdomen caused by a weakness in the aortic wall resulting in a balloon-like bulge in the artery. If untreated there is a risk of leakage or rupture, causing internal bleeding and death.

A commonly used procedure to treat AAA is known as endovascular aneurysm repair (EVAR). EVAS is an alternative minimally invasive procedure which involves the placement of stent grafts supported by expandable, polymer filled endobags. However, for a small number of people some movement of the stent grafts has been noted and if this causes blood to reenter the aneurysm, then this may require further surgical intervention, something which clinicians want to avoid.

The University of Liverpool reports its applied mathematics researchers collaborated with vascular surgeons and a vascular radiologist at the Royal Liverpool and Broadgreen University Hospital to undertake a study to map and understand the various forces and actions that affect the EVAS system.

The results of their study are published in Nature Scientific Reports.

The mathematicians were able to produce a three dimensional mathematical model that explains both static forces, for example gravity, and dynamic forces, for example vibrations from everyday activities, on the sealed abdominal aortic aneurysms which can cause movement of the stent grafts and disruption of the seal. The model took into account the pressure of the blood and the subsequent stresses and deformations in the aortic wall. It also factored in the effects of friction on the interaction between the endobags of the EVAS system and the aorta.

Alexander Movchan, Professor of Applied Mathematics at the University of Liverpool, said “We were able to apply our expertise in theoretical mathematical modelling on a very real healthcare challenge and through the research collaboration with the vascular team we produced a three-dimensional model of an AAA treated with EVAS, and its response to static and dynamic loads.”

The research was supported through the Engineering and Physical Sciences Research Council (EPSRC) Centre for New Mathematical Sciences Capabilities for Healthcare Technologies, based in the University of Liverpool’s Department of Mathematical Sciences. The centre undertakes multidisciplinary research to explore how mathematics and statistics can deliver a more refined and accurate set of predictive models and tools for personalised healthcare delivery.

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