Better treatment outcomes for patients

Computational modelling for better patient treatment outcomes

More than 100,000 people are affected every year by abdominal aortic aneurysm (AAA), which is a swelling in the main blood vessel (the aorta) that runs from the heart down through the chest, causing more than 4000 deaths per year in England and Wales. Applied mathematicians from the University of Liverpool, together with vascular surgeons, are making a clinically relevant mathematical model enabling the clinicians to recommend more personalised treatment solutions to save lives and provide better patient outcomes.

The challenge

An aortic aneurysm is a life-threatening situation, but if the symptoms are detected in time and repaired, the chances of serious damage or death can be significantly diminished.

One of the main treatment methods for AAA is called EVAS (Endovascular aneurysm sealing), a minimally invasive, special sealing method that uses a tube-like structure together with an expanding balloon filled with polymer. This relatively new technique works well for many patients, but there have been unexpected movements of the sealing structure in some patients, increasing the risk of complications.

Professor Alexander Movchan’s team at the University of Liverpool have responded to the challenge to better understand and quantify the forces leading to the detrimental movements seen after some surgeries.

Research action

Movchan and other mathematicians at Liverpool have created a theoretical 3D model that helps surgeons to judge the suitability of EVAS treatment for an individual. The group’s work has provided understanding of what anatomical characteristics might make certain patients more prone to the sealing structure movements.

They have successfully described static forces, such as the effect of gravity in different body positions, and dynamic forces from daily life, such as walking or travelling in a car, and translated their effects to the likely movements of the EVAS sealing structure.

Working in partnership

The success of the project stems from the close cooperation of the Applied Mathematics group at the University of Liverpool together with vascular surgeons and an interventional radiologist from the Royal Liverpool Hospital. The model was created based on real data from patients treated with the EVAS method.

The Mathematical Sciences group works under the new EPSRC Liverpool Centre for Mathematical Sciences in Healthcare, undertaking multidisciplinary work to tackle the serious healthcare challenges by utilising mathematics and statistics. The centre has strong collaborative links with both industry, academic institutions and NHS Trusts.

Outputs and outcomes

The pioneering computational model is based on bespoke numerical algorithms and is a major improvement in terms of delivering safe and personalised care for AAA patients.

A multi-media catalogue has been developed for vascular surgeons working on EVAS procedures and details different classes of AAA case. The model has an animation that predicts how the aneurysm, and consequently the sealing structure, might move. Medical practitioners can then make more informed decisions and treatment plans on whether the EVAS treatment is suitable for the aortic anatomy of the patient, thus avoiding post-operative complications.

The research may also help manufacturers develop better sealing structure designs that are less susceptible to the forces exerted by patients after surgery during their daily activities.

Applied mathematical techniques in collaboration with surgical expertise has led to more personalised treatment solutions and provides better patient outcomes.

Professor Alexander Movchan

Back to: Department of Mathematical Sciences