P32: Patient-specific 3D Printed Model of Thoracoabdominal Aortic Aneurysm for Stent-graft Implantation Practice

Abstract

Thoracoabdominal aortic aneurysm (TAAA) is one of the most complex and challenging arterial pathologies for the vascular surgeon. We present the case of a 69-year-old patient with TAAA, for whom a customized thoracoabdominal aortic segment model was 3D printed to test a stent-graft (E-nside TAAA, Jotec). The aim of the study was to explore the use of 3D printing in the field of vascular surgery, to simulate and practice the implantation of a stent-graft in a custom model before surgery. From the patient’s computed tomography images, a 3D digital reconstruction of the aorta was generated (Mimics Innovation Suite, Materialise) was generated by the engineering team and validated with the cardiac imaging physician. From this, the patient’s anatomical model was printed in flexible material (Agilus30, Stratasys) at the 3D Printing Center of the Fundación Cardioinfantil. The printed model was used during preoperative procedures for a demonstration with the stent-graft device. The 3D digital reconstruction showed narrow femoral accesses (6.5 right and 7 mm left) and renal arteries with diameters of 5 mm. The stent-graft was tested in the printed aorta by the specialist in charge of the procedure following the plan provided by the manufacturer. After practice, the clinical procedure was successfully performed for the first time in our institution. After normal hospital discharge, the patient was followed up one month later in an outpatient clinic without symptoms. For our institution, a limited-resource setting, 3D printing allowed for cheaper preoperative practice and planning of a new medical device, with the added value of using the patient’s anatomy. However, there are challenges regarding cost or the use of 3D printing materials that more accurately simulate vascular anatomies.