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Acta Neurochirurgica
Erschienen in: Acta Neurochirurgica 9/2016

14.07.2016 | Clinical Article - Vascular

Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms

verfasst von: Lukas Andereggen, Jan Gralla, Robert H. Andres, Stefan Weber, Gerhard Schroth, Jürgen Beck, Hans Rudolf Widmer, Michael Reinert, Andreas Raabe, Matthias Peterhans

Erschienen in: Acta Neurochirurgica | Ausgabe 9/2016

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Abstract

Background

Treatment of complex intracranial aneurysms requires strategic pre-interventional or preoperative planning. In addition to modern three-dimensional (3D) rotational angiography, computed tomography angiography (CTA) or magnetic resonance angiogram (MRA), a solid, tangible 3D model may improve anatomical comprehension and treatment planning. A 3D rapid prototyping (RP) technique based on multimodal imaging data was evaluated for use in planning of treatment for complex aneurysmal configurations.

Methods

Six patients with complex aneurysms were selected for 3D RP based on CTA and 3D rotational angiography data. Images were segmented using image-processing software to create virtual 3D models. Three-dimensional rapid prototyping techniques transformed the imaging data into physical 3D models, which were used and evaluated for interdisciplinary treatment planning.

Results

In all cases, the model provided a comprehensive 3D representation of relevant anatomical structures and improved understanding of related vessels. Based on the 3D model, primary bypass surgery with subsequent reconstruction of the aneurysm was then considered advantageous in all but one patient after simulation of multiple approaches.

Conclusions

Preoperative prediction of intraoperative anatomy using the 3D model was considered helpful for treatment planning. The use of 3D rapid prototyping may enhance understanding of complex configurations in selected large or giant aneurysms, especially those pretreated with clips or coils.
Literatur
1.
Winder J, Bibb R (2005) Medical rapid prototyping technologies: state of the art and current limitations for application in oral and maxillofacial surgery. J Oral Maxillofac Surg 63:1006–1015CrossRefPubMed
2.
Wurm G, Tomancok B, Pogady P, Holl K, Trenkler J (2004) Cerebrovascularstereolithographic biomodeling for aneurysm surgery. Technical note. J Neurosurg 100:139–145CrossRefPubMed
3.
Kondo K, Harada N, Masuda H, Sugo N, Terazono S, Okonogi S, Sakaeyama Y, Fuchinoue Y, Ando S, Fukushima D, Nomoto J, Nemoto M (2016) A neurosurgical simulation of skull base tumors using a 3D printed rapid prototyping model containing mesh structures. Acta Neurochir (Wein) 158:1213-1219
4.
Thawani JP, Pisapia JM, Singh N, Petrov D, Schuster JM, Hurst RW, Zager EL, Pukenas BA (2016) 3D-printed modeling of an arteriovenous malformation including blood flow. World Neurosurg 90:675-683.e2
5.
Schuknecht B (2007) High-concentration contrast media (HCCM) in CT angiography of the carotid system: impact on therapeutic decision making. Neuroradiology 49(Suppl 1):S15–26CrossRefPubMed
6.
Hanel RA, Spetzler RF (2008) Surgical treatment of complex intracranial aneurysms. Neurosurgery 62:1289–1297, discussion 1297–1289CrossRefPubMed
7.
Mordasini P, Kraehenbuehl AK, Byrne JV, Vandenberghe S, Reinert M, Hoppe H, Gralla J (2013) In vitro and in vivo imaging characteristics assessment of polymeric coils compared with standard platinum coils for the treatment of intracranial aneurysms. AJNR Am J Neuroradiol 34:2177–2183CrossRefPubMed
8.
Patel NV, Gounis MJ, Wakhloo AK, Noordhoek N, Blijd J, Babic D, Takhtani D, Lee SK, Norbash A (2011) Contrast-enhanced angiographic cone-beam CT of cerebrovascular stents: experimental optimization and clinical application. AJNR Am J Neuroradiol 32:137–144PubMed
9.
Hoit DA, Malek AM (2006) Fusion of three-dimensional calcium rendering with rotational angiography to guide the treatment of a giant intracranial aneurysm: technical case report. Neurosurgery 58:ONS-E173, discussion ONS-E173PubMed
10.
Jansen IG, Schneiders JJ, Potters WV, van Ooij P, van den Berg R, van Bavel E, Marquering HA, Majoie CB (2014) Generalized versus patient-specific inflowboundary conditions in computational fluid dynamics simulations of cerebral aneurysmal hemodynamics. AJNR Am J Neuroradiol 35:1543-1548
11.
Piotin M, Gailloud P, Bidaut L, Mandai S, Muster M, Moret J, Rufenacht DA (2003) CT angiography, MR angiography and rotational digital subtraction angiography forvolumetric assessment of intracranial aneurysms. An experimental study. Neuroradiology 45:404–409CrossRefPubMed
12.
D’Urso PS, Williamson OD, Thompson RG (2005) Biomodeling as an aid to spinal instrumentation. Spine (Phila Pa 1976) 30:2841–2845CrossRef
13.
Izatt MT, Thorpe PL, Thompson RG, D’Urso PS, Adam CJ, Earwaker JW, Labrom RD, Askin GN (2007) The use of physical biomodelling in complex spinal surgery. Eur Spine J 16:1507–1518CrossRefPubMedPubMedCentral
14.
Kimura T, Morita A, Nishimura K, Aiyama H, Itoh H, Fukaya S, Sora S, Ochiai C (2009) Simulation of and training for cerebral aneurysm clipping with 3-dimensional models. Neurosurgery 65:719–725, discussion 725–716CrossRefPubMed
15.
Sodian R, Weber S, Markert M, Loeff M, Lueth T, Weis FC, Daebritz S, Malec E, Schmitz C, Reichart B (2008) Pediatric cardiac transplantation: three-dimensional printing of anatomic models for surgical planning of heart transplantation in patients with univentricular heart. J Thorac Cardiovasc Surg 136:1098–1099CrossRefPubMed
16.
D’Urso PS, Thompson RG, Atkinson RL, Weidmann MJ, Redmond MJ, Hall BI, Jeavons SJ, Benson MD, Earwaker WJ (1999) Cerebrovascular biomodelling: a technical note. Surg Neurol 52:490–500CrossRefPubMed
17.
Mashiko T, Otani K, Kawano R, Konno T, Kaneko N, Ito Y, Watanabe E (2015) Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping. World Neurosurg 83:351–361CrossRefPubMed
18.
Perez-Arjona E, Dujovny M, Park H, Kulyanov D, Galaniuk A, Agner C, Michael D, Diaz FG (2003) Stereolithography: neurosurgical and medical implications. Neurol Res 25:227–236CrossRefPubMed
19.
Ryan JR, Almefty KK, Nakaji P, Frakes DH (2016) Cerebral aneurysm clipping surgery simulation using patient-specific 3D printing and silicone casting. World Neurosurg 88:175–181CrossRefPubMed
20.
Wurm G, Lehner M, Tomancok B, Kleiser R, Nussbaumer K (2011) Cerebrovascular biomodeling for aneurysm surgery: simulation-based training by means of rapid prototyping technologies. Surg Innov 18:294–306CrossRefPubMed
21.
Russin J, Babiker H, Ryan J, Rangel-Castilla L, Frakes D, Nakaji P (2015) Computational fluid dynamics to evaluate the management of a giant internal carotid artery aneurysm. World neurosurg 83:1057–1065CrossRefPubMed
22.
Arriaga AF, Bader AM, Wong JM, Lipsitz SR, Berry WR, Ziewacz JE, Hepner DL, Boorman DJ, Pozner CN, Smink DS, Gawande AA (2013) Simulation-based trial of surgical-crisis checklists. N Engl J Med 368:246–253CrossRefPubMed
23.
Arriaga AF, Gawande AA, Raemer DB, Jones DB, Smink DS, Weinstock P, Dwyer K, Lipsitz SR, Peyre S, Pawlowski JB, Muret-Wagstaff S, Gee D, Gordon JA, Cooper JB, Berry WR (2014) Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams. Ann Surg 259:403–410CrossRefPubMed
24.
25.
Waran V, Narayanan V, Karuppiah R, Owen SL, Aziz T (2014) Utility of multimaterial 3D printers in creating models with pathological entities to enhance the training experience of neurosurgeons. J Neurosurg 120:489–492CrossRefPubMed
26.
Agarwal N, Chaudhari A, Hansberry DR, Tomei KL, Prestigiacomo CJ (2013) A comparative analysis of neurosurgical online education materials to assess patient comprehension. J Clin Neurosci 20:1357–1361CrossRefPubMed
27.
King JT Jr, Yonas H, Horowitz MB, Kassam AB, Roberts MS (2005) A failure to communicate: patients with cerebral aneurysms and vascular neurosurgeons. J Neurol Neurosurg Psychiatry 76:550–554CrossRefPubMedPubMedCentral
28.
Weinstock P, Prabhu SP, Flynn K, Orbach DB, Smith E (2015) Optimizingcerebrovascular surgical and endovascular procedures in children via personalized 3D printing. J Neurosurg Pediatr 31:1–6
Metadaten
Titel
Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms
verfasst von
Lukas Andereggen
Jan Gralla
Robert H. Andres
Stefan Weber
Gerhard Schroth
Jürgen Beck
Hans Rudolf Widmer
Michael Reinert
Andreas Raabe
Matthias Peterhans
Publikationsdatum
14.07.2016
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 9/2016
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-016-2892-3

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