Towards a reduced order model for EVAR planning and intra-operative navigation.

Abstract

<h4>Introduction</h4>The pre-operative planning and intra-operative navigation of the endovascular aneurysm repair (EVAR) procedure are currently challenged by the aortic deformations that occur due to the insertion of a stiff guidewire. Hence, a fast and accurate predictive tool may help clinicians in the decision-making process and during surgical navigation, potentially reducing the radiations and contrast dose. To this aim, we generated a reduced order model (ROM) trained on parametric finite element simulations of the aortic wall-guidewire interaction.<h4>Method</h4>A Design of Experiments (DOE) consisting of 300 scenarios was created spanning over seven parameters. Radial basis functions were used to achieve a morphological parametrization of the aortic geometry. The ROM was built using 200 scenarios for training and the remaining 100 for validation.<h4>Results</h4>The developed ROM estimated the displacement of aortic nodes with a relative error below 5.5% for all the considered validation cases. From a preliminary analysis, the aortic elasticity, the stiffness of the guidewire and the tortuosity of the cannulated iliac artery proved to be the most influential parameters.<h4>Conclusions</h4>Once built, the ROM provided almost real-time and accurate estimations of the guidewire-induced aortic displacement field, thus potentially being a promising pre- and intra-operative tool for clinicians.