Comparative analysis of custom-made endograft simulation techniques: physical prototypes versus numerical simulations

Summary Background The technical success of fenestrated endovascular aortic repair (FEVAR) relies on the exact fit of the custom-made endograft in the patient. Numerical simulation software has been made available (PLANOP™, PrediSurge) to digitally test the intended endograft design. Methods The distance between opposite peaks of the proximal endograft sealing ring were measured on computed tomography (CT) scans of the test implantation within a 3D printed model, on numerical simulation software, and on postoperative CT (reference). Two types of modeling were used for the aorta in the numerical simulation software: rigid and deformable. This resulted in four measurements: (1) CT scan of the physical endograft prototype implanted in a rigid printed silicone model of the aorta, (2) rigid numerical or finite element (FE) simulation of the endograft implanted in a rigid aortic model, (3) numerical or FE simulation with a deformable virtual aortic model, and (4) patient postoperative CT. Results Ten patients were included in the study. The mean distance between peaks was 26.8 mm in the postoperative CT scan (reference). The distance in the rigid printed model was 23.8 ± 2.0 mm p