Development of Life-Size Patient-Specific 3D-Printed Dural Venous Models for Preoperative Planning.

Abstract

Despite significant improvement in clinical care, operative strategies, and technology, neurosurgery is still risky, and optimal preoperative planning and anatomical assessment are necessary to minimize the risks of serious complications. Our purpose was to document the dural venous sinuses (DVS) and their variations identified during routine 3-dimensional (3D) venography created through 3D models for the teaching of complex cerebral anatomy. 3D models of the DVS networks were printed. Compared with the controls, cases with cortical venous thrombosis have altered venous anatomy, which has not been previously compared. Geometrical changes between the neighboring DVS could be easily manipulated and explored from different angles. Modeling helped to conduct the examination in detail with reference to geometrical features of DVS, degree of asymmetry, its extension, location, and presence of hypoplasia/atresia channels. Challenging DVS anatomy was exposed with models of adverse anatomical variations of the DVS network, including highly angulated, asymmetrical view, narrowed lumens, and hypoplasia and atresia structures. It assisted us in comprehending spatial anatomy configuration of life-like models. Patient-specific models of DVS geometry could provide an improved understanding of the complex brain anatomy and better navigation in difficult areas and allow surgeons to anticipate anatomical issues that might arise during the operation. Such models offer opportunities to accelerate the development of expertise with respect to new and novel procedures as well as new surgical approaches and innovations, thus allowing novice neurosurgeons to gain valuable experience in surgical techniques without exposing patients to risk of harm.