Research progress in preoperative simulation of endovascular aneurysm repair for abdominal aortic aneurysm

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.