Personalized vascular models for optimal catheter choice: Two instances of aneurysm embolization
New developments in medical technology are revolutionising the field of aneurysm coil embolization, with 3D printed, patient-specific vascular hollow models proving particularly beneficial in complex cases.
These innovative models, designed to replicate a wide range of vascular structures with remarkable accuracy, address several limitations in traditional catheter use. They can reduce the need for catheter replacement, shorten the time required for catheter engagement and placement, and minimise the risk of intimal damage.
Two cases of complex aneurysm coil embolization have highlighted the benefits of these models. In these instances, three-dimensional, printed, patient-specific vascular hollow models were instrumental in selecting optimal catheters, leading to successful treatments.
Enhanced Preoperative Planning
These models provide a highly accurate, patient-specific anatomical representation of the aneurysm and surrounding vasculature. This improved understanding of aneurysm morphology and parent vessel anatomy helps surgeons to select appropriate devices and strategies, improving the overall safety and efficiency of the procedure.
Improved Procedural Simulation and Device Selection
3D printed models enable testing different coil sizes, shapes, and deployment techniques in a controlled environment before the actual procedure. This simulation helps predict how coils and catheters will behave in real patient anatomy, reducing procedural risks such as coil migration or incomplete occlusion.
Reduced Procedural Time and Radiation Exposure
By refining the approach beforehand, interventionists can minimise trial-and-error during the embolization, which lowers fluoroscopy time, contrast use, and overall procedure duration, enhancing patient safety and efficiency.
Better Communication and Training
These models serve as valuable educational tools for the surgical team and can facilitate patient communication, making it easier to explain the procedure and expected outcomes.
Potential to Improve Outcomes
By enabling more precise device deployment and effective aneurysm occlusion, patient-specific 3D models may lead to fewer complications and improved long-term outcomes.
While the search results do not directly detail all these benefits specifically for aneurysm coil embolization, related literature on advanced surgical embolization techniques and simulation modeling underscores the advantages of precise, patient-specific anatomical replication for complex endovascular procedures.
However, direct evidence from the provided documents explicitly describing 3D printed hollow vascular models for aneurysm coiling is lacking. Nevertheless, related insights on preoperative embolization and simulation support these inferred benefits.
For instance, preoperative computed tomography (CT) imaging often fails to provide adequate information about the compatibility of the chosen catheter shape with the primary branch originating from the aorta. Using a 4.5-Fr guiding sheath and a 4-Fr Roesch hepatic catheter was determined to provide sufficient backup support for accurate coil placement during the simulation.
The institutional review board approved the use of vascular models for a retrospective case report. A female patient in her 40s presented with a 5 × 5 mm saccular aneurysm at the origin of the dorsal pancreatic artery. Preoperative simulations using the developed model were performed to select the optimal catheter shape for successful treatment.
In complex and anatomically challenging cases of interventional radiology, patient-specific vascular models are increasingly being used for preoperative planning. Digital Imaging and Communications in Medicine (DICOM) data from three-dimensional (3D) computed tomographic angiography (CTA) images were converted to stereolithography (STL) files. The models were coated with silicone and connected to a sheath in a white box to simulate endovascular procedures without fluoroscopy.
The vascular models were printed using a Form 3L 3D printer with flexible, transparent materials. The hollow feature of the model was created using MeshMixer with a wall thickness of 1.0 mm. Most existing models either lack hollow structures or are small-scale hollow models that fail to reproduce the extended access route from the femoral, radial, or brachial arteries.
The same catheters were used during the actual procedure, and embolization was successfully completed with no complications. The patient was referred to the department for prevention of aneurysm rupture due to the proximity of the aneurysm to the SMA trunk. Preoperative simulations using this model have been reported to improve embolization material selection and device access, including identifying the most suitable catheter and guidewire.
Multiple catheter exchanges during the procedure may become necessary, leading to prolonged procedure times and increased risk of vascular intimal injury. By using these 3D printed, patient-specific vascular hollow models, surgeons can minimise the need for such exchanges, further enhancing the safety and efficiency of the procedure.
- Science and technology are transforming interventional radiology, particularly in complex medical-conditions like aneurysm coil embolization, with 3D printed, patient-specific vascular hollow models contributing significantly.
- These 3D models, accurate replicas of a patient's anatomy, are essential for improved preoperative planning, as they facilitate better understanding of aneurysm morphology and parent vessel anatomy, enhancing the selection of appropriate devices and strategies.
- The use of these models in health-and-wellness procedures such as aneurysm coil embolization can also reduce procedural time, radiation exposure, and the need for multiple catheter exchanges, making them valuable additions to the medical-tools (gadgets) available in the field of cardiovascular-health.
