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TERATEC 2017 Forum
Workshop 2 - Wednesday, June 28 from 9h00 to 12h30
Health - Perspectives for Personalized Medicine in 2025

Towards real time simulations of the rationale behind clinical decisions in surgery
Stéphane AVRIL, Mines Saint-Etienne, Director of the Center for Biomedical and healthcare Engineering - CIS, Deputy Director of INSERM U1059 – SAINBIOSE

Abstract : Cardiovascular diseases are one of the leading causes of death in industrialized countries. In this context, surgery has undergone a major technological evolution for 20 years with the development of endovascular interventions and the systematic use of 3D / 4D imaging in X-ray tomography and now in MRI.
Nevertheless, the technical difficulties encountered during surgical procedures remain very important. The consequences of complications (thrombosis, perforation) can be very serious (hemorrhage, renal insufficiency with dialysis, necrosis of the intestine, liver insufficiency) and put into play the life of the patient, which unfortunately happens for about 10 to 20 % of cases.

In order to eradicate these complications, we have developed realistic, personalized and predictive numerical simulation tools that allow anticipating these risks and thus avoiding them by securing the intervention. We now have demonstrators undergoing medical and technological validation, up to the phase before the evaluation of the expected medical service. These demonstrators are currently being tested by clinicians, allowing selection of endovascular tools, tool / tissue interactions and activation of simulation results to return relevant information to the user.

These developments position us today on the path of the simulation of clinical reasoning in vascular surgery. The immediate issue is to be able to simulate this reasoning in real time, which represents a scientific lock that we expect to lift within 3 years.

The next step is to simulate the outcome of long-term surgical actions by modeling tissues at the cellular and mechano-chemo-biological level. This is also what we are working on with ERC funding: numerical simulation of the mechanisms by which tissues are damaged (under the influence of aging) and how these mechanisms can lead to their rupture, numerical simulation of mechanisms Microstructural studies of the resistance of the arteries subjected to various types of stresses, numerical simulation of the growth scenario and remodeling of the aneurysm of each patient, using 4D MRI data.

All this, once integrated in augmented reality platforms, will allow the surgeon to be able to evaluate in real time the possible impact of his decisions so that each patient can be taken care of with a zero risk of complication.

Biography : Stéphane Avril is Full Professor at Institut Mines Telecom - Mines Saint-Etienne - University of Lyon in France where he runs a group of 20+ in soft tissue biomechanics, with a special focus on constitutive modeling and identification using imaging techniques. He is also director of the CIS center for biomedical and healthcare engineering (65+ people). Stéphane received his PhD in mechanical and civil engineering in 2002 at Mines Saint-Etienne (France). After post-docs at Arts et Métiers ParisTech (France) and Loughborough University (UK), Stéphane became assistant Professor at Arts et Métiers ParisTech (France) where he developed the Virtual Fields Methods, which is now used worldwide to reconstruct material properties from full-field measurements in solid mechanics. In 2008, he returned to his alma mater on a position of associate professor and extended his broad experience of inverse problems to soft tissue biomechanics, especially regarding aortic aneurisms in close collaboration with vascular surgeons. He became full professor in 2010. Stéphane was a visiting Professor at the University of Michigan Ann Arbor in 2008 with Prof R Berguer and a visiting professor at Yale University in 2014 and 2016 with Prof J Humphrey. In 2015, Stéphane was awarded an ERC (European Research Council) consolidator grant of 2m€ for the Biolochanics project on: Localization in biomechanics and mechanobiology of aneurysms: Towards personalized medicine..

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Find the technical workshops of the TERATEC Forum on the theme of HPC in health and download the presentations

Teratec 2016 Forum : HPC technologies and applications in the healthcare sector

Teratec 2014 Forum : HPC and Healthcare: From therapeutic research to personalized medicine

Teratec 2013 Forum : HPC in Biology and Health

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