GIMC SIMAI Young 2026

Predicting post-TEVAR endoleaks: a pre-operative hemodynamic risk factor from patient-specific Fluid-Structure Interaction simulations

4 Jun 2026, 12:00

15m

Aula C

MS09 - Advances and Open Problems in CFD and FSI for Bioengineering Applications MS09+MS12 - Advances and Open Problems in CFD and FSI for Bioengineering Applications

Speaker

Francesca Duca (Labs - Dipartimento di Chimica, Materiali e Ingegneria Chimica - Politecnico di Milano, Milan, Italy)

Description

Thoracic Endovascular Aortic Repair (TEVAR) is a minimally invasive procedure for the treatment of Thoracic Aorta (TA) pathologies, such as Thoracic Aortic Aneurysm (TAA). Computational simulations can provide valuable insights into TEVAR outcomes and complications (e.g., endoleaks) prior to surgery, making them a useful tool in the procedural planning. In this context, we develop a Fluid-Structure Interaction (FSI) computational framework to analyse the hemodynamics in different TAA scenarios. In this FSI model, blood is assumed to be Newtonian, homogeneous, and incompressible, and its behaviour is modelled with the Navier-Stokes equations written in the Arbitrary Lagrangian-Eulerian formulation. To account for transition to turbulence, particularly relevant in presence of TAA, the σ-model Large Eddy Simulation turbulence model is adopted. The aortic wall is assumed to be incompressible, and its dynamics is modelled using linear elasticity. The Young’s modulus of the healthy portion of the TA is set equal to 0.8 MPa, while for the aneurysmal region, a higher value of 1.2 MPa is imposed. For the fluid sub-problem, a physiological time-dependent pressure wave is imposed as inlet Boundary Condition (BC), an absorbing BC consisting of a single resistance is prescribed at each supraortics outlets, and a 3-element Windkessel model is applied at the descending TA outlet. For the structural sub-problem, on the external surface, a Robin BC is prescribed to model the constraint exerted by the surrounding tissue on the vessel’s movements. By means of this FSI model, we simulate the hemodynamics in ten pre-TEVAR patient-specific TAA scenarios, for which post-TEVAR outcomes (i.e., endoleak presence or absence) are known, to design a new hemodynamic risk factor able to predict post-TEVAR endoleaks. Then, we validate the risk factor prediction using post-TEVAR follow-up outcomes available for each patient-specific case. This is a first attempt to determine whether pre-TEVAR hemodynamics can effectively predict post-TEVAR complications.