Surgical stent planning: simulation parameter study for models based on DICOM standards

Purpose Endovascular Aneurysm Repair (EVAR) can be facilitated by a realistic simulation model of stent-vessel-interaction. Therefore, numerical feasibility and integrability in the clinical environment was evaluated. Methods The finite element method was used to determine necessary simulation parameters for stent-vessel-interaction in EVAR. Input variables and result data of the simulation model were examined for their standardization using DICOM supplements. Results The study identified four essential parameters for the stent-vessel simulation: blood pressure, intima constitution, plaque occurrence and the material properties of vessel and plaque. Output quantities such as radial force of the stent and contact pressure between stent/vessel can help the surgeon to evaluate implant fixation and sealing. The model geometry can be saved with DICOM Surface Segmentation objects and the upcoming Implant Templates supplement. Simulation results can be stored using the Structured Report. Conclusions A standards-based general simulation model for optimizing stent-graft selection may be feasible. At present, there are limitations due to specification of individual vessel material parameters and for simulating the proximal fixation of stent-grafts with hooks. Simulation data with clinical relevance for documentation and presentation can be stored using existing or new DICOM extensions.