A Novel Patient-Specific Human Cardiovascular System Phantom (HCSP) for Reconstructions of Pulsatile Blood Hemodynamic Inside Abdominal Aortic Aneurysm

Background and objectives: Post-operative complications of endovascular aneurysm repair, such as endoleaks, migration, or angular bands in a stent-graft or narrowing and occlusion of a stent-graft lumen are potentially life-threatening and difficult to perceive without constant monitoring. Therefore, our work aimed to propose a new ex-vivo system called Human-Cardiovascular-System-Phantom (HCSP) to simulate pulsatile hemodynamic in the abdominal aortic aneurysm (AAA) before and after stent-graft placement. Materials and Methods: To verify the system twelve AAA-models, before and after medical treatment, were reconstructed based on medical data from AngioCT and US-Doppler. Furthermore, the 3D printed models were installed in the HCSP to reconstruct pulsatile flow and mechanical behavior of the aortic aneurysm wall which was tracked with DC. Clinical data, including results from 2D-Speckle-tracking-technique (2DSTT), were also used to verify wall deformation for heart rate ranging between 60 to 120 min^-1, and were confronted with results on wall deformation measured with DC in 3D printed aneurysms. Results: HCSP was able to track and calculate wall deformation with accuracy from 94.4% to 100% compared to 2DSTT. Wall deformation calculated with DC did not statistically vary from 2DSTT values. For instance, wall deformation measured with 2DSTT for anterior position and for 70 min^-1 was equal to 4.18±0.05 mm, 3.70±0.08 mm and 2.00±0.08 mm for AAA, AAA+thrombus and AAA+stent-graft, respectively. Those values were comparable with those measured with DC. Conclusions: The proposed HCSP allows to successfully follow hemodynamic changes in the AAA-model with thrombus or stent-graft and under different hemodynamic conditions. Thus, our approach may be useful in monitoring the influence of a stent-graft's spatial configuration on different hemodynamic parameters inside the AAA in the laboratory conditions.