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Analyse des performances mécaniques des endoprothèses aortiques par simulation numérique : Application au traitement des anévrismes tortueux.

Abstract : The aim of the endovascular repair (EVAR) of abdominal aortic aneurysm (AAA) is to set up a stent-graft (SG) within the aneurysm in order to avoid its rupture. This surgery is mini-invasive and can be used for patients who are ineligible for open surgery. However, complications mainly due to mechanical issues can occur during patient follow-up, such as endoleak or stenosis for example. A better knowledge of SG mechanical behaviour could be useful to improve SG design and durability which still prevents surgeons to use this treatment systematically. A new methodology to model multi-material SGs has been developed. Special attention has been paid to the mechanical characterization of stent and graft materials. SG numerical models have been qualitatively and quantitatively validated on a bending test by the means of tomographic acquisitions and image processing, showing their reliability. Mechanical performances of several marketed SGs have been assessed through various tests increasingly closer to the in vivo conditions undergone by the devices. SGs have been subjected to pure bending tests, then to tests combining bending and pressurisation. SG flexibility and components mechanical response have been compared and SGs have been ranked according to their performances. It has been shown that SG architecture has a significant influence on SG mechanical performances. Finally, SG deployment within two aneurysm models has been successfully simulated. The latter study highlighted other complications, like type I endoleak. This work has many promising perspectives, especially the development of a computer-aided surgery.Finite element analysis of the mechanical performances of aortic stent-grafts: application to the treatment of tortuous aneurysms.
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Submitted on : Saturday, February 2, 2013 - 7:22:13 PM
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Nicolas Demanget. Analyse des performances mécaniques des endoprothèses aortiques par simulation numérique : Application au traitement des anévrismes tortueux.. Autre. Ecole Nationale Supérieure des Mines de Saint-Etienne, 2012. Français. ⟨NNT : 2012EMSE0673⟩. ⟨tel-00784008⟩

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