A Workflow for the Numerical Evaluation of Hemodynamics in a Patient-Specific AAA After Stent-Graft Implantation

An Abdominal Aortic Aneurysm (AAA) is a focal dilatation of the abdominal aorta, which if not treated can rupture with catastrophic internal bleeding. Besides open surgery, minimally invasive EndoVascular Aneurysm Repair (EVAR) has gradually taken place in clinical practice. In this paper, a workflow to evaluate the hemodynamic changes in a patient-specific AAA after stent-graft implantation is proposed. After the extraction from Computed Tomography (CT) images of the AAA 3D model, a patient-specific idealized stent-graft was obtained by means of CAD software. Models were then imported into the simulation environment, where a proper mesh was generated. Once calculations were completed, parameters of interest were extracted and a comparison between values before and after stent-graft implantation was conducted. Results show that, as expected, the introduction of the stent-graft makes the flow pattern smoother and more regular, with no vortices. This is because the stent provides a more physiological geometry for the blood flow, without the aneurysm enlargement. Anyway, simulations were conducted in a simplified way, being the main aim of the paper the implementation of the workflow by which parameters of interest can be obtained. As a development, the introduction of more refined boundary conditions, maybe considering data of the real patient, would increase the reliability of the simulations. A further step would be the passage from Computational Fluid Dynamics (CFD) to Fluid-Structure Interaction (FSI) simulations, so considering wall vessel compliance.