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Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00

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Jeffrey Nagel (University of Twente)
Hadi Mirgolbabaee (University of Twente)
Michel Versluis (University of Twente)
Michel Reijnen (University of Twente, Rijnstate hospital)
Erik Groot Jebbink (University of Twente, Rijnstate hospital)

Abstract:
An abdominal aortic aneurysm (AAA) is a permanent dilatation of the abdominal aorta. Depending on the size of the aneurysm and its growth rate, treatment varies from watchful waiting to surgery. With the development of new and advanced imaging and treatment techniques for AAAs, physical and digital vascular phantoms have become an important tool for validation and training. However, current phantoms are typically based on very basic models, often without a relevant physiological geometry of the branching vessels, or they are patient-specific, limiting the generalizability of results. Having access to average models with a more realistic geometry could prove beneficial in making more accurate phantoms and would allow investigation and comparison of anatomical differences between patient groups, linked to clinical outcome after endovascular aneurysm repair (EVAR). Here, we develop an average model with a realistic geometry of the AAA. The abdominal aorta was segmented from CTA scans of 64 patients that underwent elective EVAR. For each patient, two segmentations were made using Materialise Mimics software; one of the flow lumen and one of the aortic wall, including the mural thrombus. The centre lumen line (CLL) was extracted from the segmentations and all CLLs were registered to the same coordinate system. The CLL was divided into sections based on the branches of the abdominal aorta – aorta, renal arteries and common, internal and external iliac arteries – and each section was sampled at a constant sampling rate between segmentations. At each sampling point the cross-sectional area of the lumen was determined, from which the lumen diameter was calculated. The CLL coordinates and the corresponding lumen diameters were averaged at each point, and computer-aided design software (SolidWorks) was used to convert them into an average 3D model of the abdominal aorta. A phantom was 3D printed for future in vitro experiments, using flexible 80A resin from Formlabs. In future studies we will also make models of specific subsets of patient groups, based on treatment outcomes, using principal component analysis to investigate whether geometrical features can be used to predict potential complications after EVAR, such as limb occlusion and type I endoleak.