Abstract
Three dimensional printing (3D printing) technology is increasingly used to improve results in many areas of medicine. Physical models produced by this technology allow better appreciation of complex anatomical and pathologic conditions. In cardiovascular medicine and surgery, 3D modeling has been reported to be of help in treatment planning of abdominal aortic aneurysm, especially in cases of complex angulations and branching at the aneurysm neck. Here we report the use of 3D printing in cases of renal aneurysms. Enhanced 3D models of CTA images of renal aneurysms were prepared in house using common and freely available software programs, and an accurate desktop 3D printer. Eight reconstructed models were enlarged by a factor of 2 or more and then differentially painted to delineate normal arteries and aneurysmatic ones. These enhanced 3D solid models allowed visual and tactile inspection for a better appreciation of complex aneurysms. Color enhancement of these models added another dimension of comprehension, even for experienced surgeons and invasive radiologists, and allowed more accurate measurements of branch numbers, distances, and angles in space even with severe tortuosity. Endovascular use of covered stents and embolization techniques could be easily envisioned preoperatively. We conclude that enhanced, enlarged, and colored 3D printed models are a powerful tool for preoperative endovascular treatment planning of complex renal artery aneurysms.
Highlights
Renal artery aneurysms (RAA) are a rare entity with an unknown true prevalence
Accurate preoperative measurements and stent planning in daily practice are usually based on two dimensional (2D) reconstructions of the computerized tomography angiography (CTA) images utilizing centerline based dimension measurements, or by three dimensional (3D) reconstructions of the 2D images [5]
The fabricated enhanced RAA 3D models were conveniently held in hand, turned in all directions and carefully inspected from all angles
Summary
Renal artery aneurysms (RAA) are a rare entity with an unknown true prevalence. The reported rates of incidence varied between 0.3 - 1.3 percent of all aneurysm in large series [1]. They are usually asymptomatic but may rupture and cause severe morbidity and mortality, presumably as they become large [2]. Renal artery aneurysms present a real treatment challenges because of their position, size, spatial complexity, and high variability of branches [4]. In some cases of complex RAA, the real dimensions are very difficult to comprehend even by experienced surgeons and radiologists. It was felt that for those selected difficult cases, better methods should be explored
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