Kameel Khabaz

School: The University of Chicago

Major: Biological Sciences

DOI: https://doi.org/10.21985/n2-jhen-1k11

Kameel Khabaz is a first-year undergraduate at the University of Chicago from Irvine, California, majoring in Biological Sciences with a Specialization in Quantitative Biology. Having taken a number of STEM classes and reached the Finals of the USA Biology Olympiad in high school, he loves learning about science and mathematics. He is also an eager researcher, currently studying the geometric characterization of type B aortic dissections at the Department of Surgery and having worked on several projects at the University of California, Irvine, and the University of Southern California since his sophomore year of high school. In the future, he plans to connect his research with his passion for clinical medicine and surgery. In his free time, he enjoys spending time with friends and family, as well as playing tennis, running, and biking.

Aortic Surface Geometry as an Indicator of Successful Thoracic Endovascular Aortic Repair

Abstract

Acute type B aortic dissections (TBAD) are a challenging clinical problem. Medical management has remained the mainstay treatment of uncomplicated TBAD for decades. With the advent of  thoracic endovascular aortic repair (TEVAR), the role of surgery is increasing. A challenge with endovascular repairs, unlike traditional open operations, is monitoring aortic remodeling post-intervention. A global approach to measuring and characterizing aortic geometry pre- and post-TEVAR is needed. We use computed tomography angiography (CTA) imaging-based meshed aortic models to calculate surface curvature and characterize aortic geometry. We study three TBAD patients with three characteristic clinical outcomes: complete aortic remodeling over 12 months post-intervention, false lumen thrombosis with partial remodeling, and failed remodeling with post-procedural complications. We perform pre- and post-op segmentations of the true lumen, false lumen, and aortic wall from CTA scans. The curvature tensor is calculated for each geometry, allowing us to measure the principle curvatures and their directions along the aortic surfaces. We visualize and measure the evolution of aortic geometry by plotting Gaussian curvature as a heatmap over each surface. We found that our  three patients characterize three categories of post-TEVAR aortic remodeling, contingent upon the pre-operative similarity of the geometries of the aorta and its true lumen. When the pre-operative aortic and true lumen geometries were the most similar, remodeling was mostly localized to the true lumen, whose geometry changed to match that of the aorta. In the intermediate case of dissimilarity, the entire aorta remodeled as both the aortic and true lumen geometries approached each other post-TEVAR. In the case that the pre-operative geometries are highly dissimilar, no substantial trend was observed. Our next steps include investigating the aforementioned changes in different sets of patients as well as elucidating the mechanism of post-TEVAR aortic remodeling.