Surface Geometry Analysis of Pathological Aortas for Endovascular Aortic Repair*

Endovascular repair (EVAR) is a surgical method to remodel abdominal aortic aneurysms (AAA) by restricting blood flow into the aneurysm sac by inserting a cylindrical stent. However, when the biomechanical stability between the proximal seal zone of the cylindrical stent and ill-defined geometry of the AAA is compromised, Type 1A endoleaks occur, which is persistent perigraft blood flow between the endograft and aortic wall. The complexities of Type IA endoleaks indicate a lack of understanding of the biomechanical interface and geometric compatibility between the two surfaces. The goal of this project is to compare the surface geometry, specifically the curvedness and shape index of aortas that demonstrated successful remodeling after EVAR and aortas with persistent Type 1A endoleaks. We plot the changes of the mean shape index vs. curvedness of the AAAs pre-op and post-op and observed that there is a clear distinction in the trajectories of the surface geometry changes between the two cohorts. By further understanding the 3D geometry of these two cohorts, we hypothesize that we will be able to predict the remodeling potential of AAA.