Evaluation of Type I endoleak after endovascular aneurysm repair for abdominal aortic aneurysm using component quantification of energy loss: a preliminary feasibility study

Objective This study aimed to perform hemodynamic simulations using patient-specific models of abdominal aortic aneurysms (AAA) following endovascular aneurysm repair (EVAR) to investigate the association between energy loss (EL) and Type I endoleak. Methods Pre- and post-EVAR models were reconstructed from computed tomography angiography (CTA) for four patients with Type I endoleak and four without. Component quantification of EL, along with wall shear stress (WSS)-related hemodynamic parameters, were employed to evaluate the potential of endoleak. Results Endoleaks following EVAR tended to occur at the junction of stent grafts, where high time-averaged wall shear stress (TAWSS), high turbulence EL, and high mean flow EL were observed. The turbulence EL values for the main stents, left iliac branch stents, and right iliac branch stents in the endoleak group were 516 ± 183*10 −6 W, 828 ± 195*10 −6 W, and 609 ± 193*10 −6 W, respectively, and the mean flow EL for those regions were 363 ± 125*10 −6 W, 631 ± 138*10 −6 W, and 352 ± 162*10 −6 W, respectively. Compared with the no endoleak group, the endoleak group exhibited significantly higher turbulence EL and mean flow EL at the iliac branch and main stent, whereas no significant difference in TAWSS was found. Conclusion Component quantification of EL demonstrated preliminary feasibility for evaluating Type I endoleak in patients with EVAR for AAA, demonstrating greater advantages over WSS-related hemodynamic parameters. This method may provide valuable support for clinicians in assessing surgical prognosis.