Arterial clamping: finite element simulation and in vivo validation

Abstract

Commonly used techniques in cardiovascular interventions such as arterial clamping always entail a certain degree of unavoidable iatrogenic tissue damage. Therefore, studies have been directed towards the decrease of undesired intraoperative trauma, for example, through the design of less traumatic surgical instruments. Obviously, the effectiveness of new clamp designs and techniques depends on how well damage mechanisms are understood and how accurate thresholds for safe tissue loading can be set. This information can in part be derived from reliable finite element simulations. This study is the first to describe a finite element simulation of the clamping of a rat abdominal aorta with occlusion and in vivo validation. Material nonlinearity, large deformations, contact interactions and residual strains are hereby taken into account. The mechanical parameters of the model are derived from inflation experiments. The effect of the residual strains, different clamp geometries as well as the effect of variations in material properties are studied. In all simulations, stress concentrations in different regions of the tissue are noticed, especially for a corrugated clamp design. This shows the importance of finite element modeling in understanding the relation between mechanical loading and damage mechanisms. The inclusion of residual strains has its effect not only in the physiological loading regime, but also during clamping. Just as in the physiologic regime, it lowers the stress gradients through the wall thickness. Varying the material properties with the measured standard deviation between specimens leads to an average change of ±17% in the maximum and minimum principal stresses. Finally, the model is validated with an in vivo clamping experiment on a Wistar rat in which the clamping force was measured, showing good correspondence with the modeled clamping force.