Preoperative simulation integrating 3D reconstruction, AI, and computational mechanics enhances EVAR planning by guiding precise stent-graft sizing, reducing contrast usage, and predicting complications.
Does preoperative simulation improve procedural planning and outcomes in patients undergoing EVAR for abdominal aortic aneurysms?
Advanced preoperative simulation integrating AI, 3D reconstruction, and computational mechanics enhances EVAR planning by improving stent-graft sizing and predicting complications, though computational and modeling challenges remain.
This review synthesizes advances in preoperative simulation for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA). While EVAR is the first-line therapy, its success is critically dependent on precise planning. Conventional 2D imaging often fails to address complex anatomical variations. Preoperative simulation integrates 3D reconstruction, computational mechanics (FEA/CFD/FSI), and artificial intelligence to enable personalized treatment. AI accelerates image segmentation to the minute-level and enhances the accuracy of rupture risk prediction, while 3D printing and VR/AR optimize procedural rehearsal and training. Clinical implementation demonstrates that this technology guides precise stent-graft sizing, reduces contrast agent usage, and predicts complications. Although software platforms such as Mimics, Abaqus, and Endosize have proven valuable, challenges persist regarding high computational demands, insufficient dynamic physiological modeling, and interdisciplinary barriers. Future efforts should focus on fully automated segmentation algorithms and digital twin frameworks to transition preoperative simulation from an auxiliary tool to a core decision-making infrastructure in precision vascular surgery.
Liu et al. (Thu,) conducted a review in Abdominal aortic aneurysm (AAA). Preoperative simulation (3D reconstruction, computational mechanics, AI) vs. Conventional 2D imaging was evaluated. Preoperative simulation integrating 3D reconstruction, AI, and computational mechanics enhances EVAR planning by guiding precise stent-graft sizing, reducing contrast usage, and predicting complications.