3D Printed Models-A Useful Tool in Endovascular Treatment of Intracranial Aneurysms.

Bogdan Ionut Dobrovat,Lucian Eva,Daniel Marciuc,Nicolaie Dobrin,Danisia Haba,Alexandru Chiriac,Emilia Adriana Marciuc,Roxana Mihaela Popescu

doi:10.3390/brainsci11050598

Abstract

Many developments were made in the area of endovascular treatment of intracranial aneurysms, but this procedure also requires a good assessment of vascular anatomy prior to intervention. Seventy-six cases with brain aneurysms were selected and 1:1 scale 3D printed models were created. We asked three interventional neurosurgeons with different degrees of experience (ten years, four years, and a fourth-year resident) to review the cases using CTA (computed tomography angiogram) with MPR (multiplanar reconstructions) and VRT (volume rendering technique) and make a decision: coil embolization or stent-assisted coil embolization. After we provided them with the 3D printed models, they were asked to review their treatment plan. Statistical analysis was performed and the endovascular approach changed in 11.84% of cases for ten-year experienced neurosurgeons, 13.15% for four years experienced neurosurgeon, and 21.05% for residents. The interobserver agreement was very good between the ten years experienced interventionist and four years experienced interventionist when they analyzed the data set that included the 3D printed model. The agreement was higher between all physicians after they examined the printed model. 3D patient-specific printed models may be useful in choosing between two different endovascular techniques and also help the residents to better understand the vascular anatomy and the overall procedure.

Highlights

Intracranial aneurysms are vascular lesions that are often asymptomatic, but when rupture occurs, the consequences can be devastating
Despite the advances made in imaging and postprocessing tools with multiplanar reconstructions and volume rendering techniques that enable a better overall understanding of the aneurysms [5,6], three dimensional (3D) technology provides another perspective with a tangible 3D printed model, neurosurgeons being able to visualize an aneurysm beyond a flat-screen
The aim of this study is to evaluate the role of 3D patient-specific printed models in establishing the endovascular approach in 76 cerebral aneurysms and the agreement among more or less experienced interventional neurosurgeons

Summary

Introduction

Intracranial aneurysms are vascular lesions that are often asymptomatic, but when rupture occurs, the consequences can be devastating. After ISAT study publication [2] and an increased number of patients treated endovascularly, there were many developments regarding this treatment technique [3,4], but still, it requires a very good understanding of the patient’s specific vascular anatomy. Despite the advances made in imaging and postprocessing tools with multiplanar reconstructions and volume rendering techniques that enable a better overall understanding of the aneurysms [5,6], three dimensional (3D) technology provides another perspective with a tangible 3D printed model, neurosurgeons being able to visualize an aneurysm beyond a flat-screen. The aim of this study is to evaluate the role of 3D patient-specific printed models in establishing the endovascular approach (coil embolization or stent-assisted coil embolization) in 76 cerebral aneurysms and the agreement among more or less experienced interventional neurosurgeons

Objectives

Methods

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Discussion

Conclusion