3D printing in the planning and teaching of endovascular procedures.

Abstract

The introduction of 3D printing in the medical field led to new possibilities in the planning of complex procedures, as well as new ways of training junior physicians. Especially in the field of vascular interventions, 3D printing has awide range of applications. 3D-printed models of aortic aneurysms can be used for procedural training of endovascular aortic repair (EVAR), which can help boost the physician's confidence in the procedure, leading to abetter outcome for the patient. Furthermore, it allows for abetter understanding of complex anatomies and pathologies. In addition to teaching applications, the field of pre-interventional planning benefits greatly from the addition of 3D printing. Especially in the preparation for acomplex endovascular aortic repair, prior orientation and test implantation of the stent grafts can further improve outcomes and reduce complications. For both teaching and planning applications, high-quality imaging datasets are required that can be transferred into adigital 3D model and subsequently printed in 3D. Thick slice thickness or suboptimal contrast agent phase can reduce the overall detail of the digital model, possibly concealing crucial anatomical details. Based on the digital 3D model created for 3D printing, another new visualization technique might see future applications in the field of vascular interventions: virtual reality (VR). It enables the physician to quickly visualize adigital 3D model of the patient's anatomy in order to assess possible complications during endovascular repair. Due to the short transfer time from the radiological dataset into the VR, this technique might see use in emergency situations, where there is no time to wait for aprinted model.