Download or read book The Role of Abdominal Aortic Aneurysm Wall Biomechanics in Endovascular Repair Assessment written by Zinan He and published by . This book was released on 2021 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Cardiovascular disease is a leading cause of death around the world. In particular, abdominal aortic aneurysm (AAA) is a top silent killer and even claimed the life of our eminent scientist Albert Einstein. Symptoms often only appear in the late stages, and since AAA involves the main artery carrying blood from the heart to the torso, it may trigger catastrophic events such as rupture and coincides with a mortality up to 90%. The prevalence in western countries is especially high, around 20,000 patients are diagnosed with AAA every year in Canada, and AAA rupture has been ranked the 15th leading cause of death for the past two decades in the United Sates. Endovascular repair (EVAR), a minimally invasive AAA treatment, was introduced in the 90’s and is considered as a promising option compared to the traditional open surgery. Regardless of the significant reduction in surgical risks and recovery time, no difference has been reported for the long-term outcome, mainly due to graft related complications. Therefore, better understanding the biomechanics of AAA, particularly in contact with endovascular devices, will provide an essential path to improve endovascular treatments.Although the biomechanics of AAA has been extensively investigated, efforts have mostly been devoted to the risks of major AAA characteristics associated with vascular rupture, such as stiffened wall, gigantic thrombus and calcification. The roles of those characteristics during the interaction with endovascular devices remain to be elucidated. Moreover, controversial understanding on the role of calcification (Ca) persists, partly due to its complicated nature and morphological variability, often resulting in oversimplification or exclusion from clinical evaluations. The intrinsic property of Ca has always been considered, however the combined effects of Ca shapes and locations have been questioned but not yet addressed. Besides, most studies have focused on major AAA characteristics, but rarely on the surrounding tissues, such as the abdominal fat despite its high prevalence. Hence, further research on the biomechanical response of AAA during EVAR, taking into account both the major AAA characteristics and the surrounding tissues, is sought.Consequently, the main objective of this thesis is to provide insight into the role of AAA wall biomechanics, specifically for the aortic Ca and surrounding tissues, in EVAR assessment. A novel quantitative and qualitative analysis, using 3D models reconstructed from clinical data to describe the extent, shape and location of Ca, has been conducted to investigate the effects of Ca morphological characteristics on EVAR outcomes. In addition, a series of hydrogel-based anthropomorphic mockups simulating the mechanical, anatomical and pathological characteristics of AAA have been developed for the first time, in order to evaluate the biomechanical interaction between endovascular devices and AAA, with and without the presence of surrounding abdominal fat. Results from Ca analysis confirmed that, not only the intrinsic properties but also the morphological characteristics of Ca, can together alter the global behavior of AAA, thus playing an essential role in EVAR assessment. Specifically, including the combined effects from Ca morphological characteristics can lead to very different prediction compared to conventional assessment, where the intrinsic property is merely considered. Furthermore, results from AAA mockup analysis highlighted the indispensable role of surrounding tissues, not only the spine but also the abdominal fat, as to account for realistic interactions with endovascular devices. The discoveries and novel approaches within the scope of this thesis have potential clinical significance which, with future revisions and validation, could improve the current knowledge in AAA biomechanics and EVAR assessment"--