A 3D Printed Aortic Arch Template to Facilitate Decision-Making Regarding the Use of an Externalized Transapical Wire during Thoracic Endovascular Aneurysm Repair

Rynio, Paweł; Kazimierczak, Arkadiusz; Jędrzejczak, Tomasz; Gutowski, Piotr

doi:10.1016/j.avsg.2018.06.021

Cited by 14 publications

(16 citation statements)

References 9 publications

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“…The skin template was then used to cover the stent graft prior to the surgical procedure for providing accurate location of fenestration holes on the stent graft. This novel approach for improving fenestration accuracy on the stent graft was further confirmed by Rynio et al who produced a 3D printed aortic arch template from CT angiographic data to improve accuracy and effective management of thoracic aortic aneurysms by the fenestrated and modified stent grafts [74].…”

Section: D Printing In Aortic Aneurysm and Aortic Dissectionmentioning

confidence: 83%

“…Clinical value of 3D printing in aortic disease, mainly aortic aneurysm and dissection is also dominated by isolated case reports showing its application of creating realistic aortic models for simulation of surgical procedures, in particular minimally invasive endovascular stent grafting procedures of treating abdominal aortic aneurysm (AAA) and aortic dissection [65][66][67][68][69][70][71][72][73][74]. Tam et al analysed 42 studies in their systematic review, with nearly 50% of them (20 studies) related to 3D printing in AAA, eight out of 42 studies on thoracic aorta pathology, and the remaining reports on 3D printing in other vascular diseases, such as carotid, subclavian, celiac, and femoral arteries [75].…”

Section: D Printing In Aortic Aneurysm and Aortic Dissectionmentioning

confidence: 99%

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Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Sun

2020

Biomolecules

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Three-dimensional (3D) printing has been increasingly used in medicine with applications in many different fields ranging from orthopaedics and tumours to cardiovascular disease. Realistic 3D models can be printed with different materials to replicate anatomical structures and pathologies with high accuracy. 3D printed models generated from medical imaging data acquired with computed tomography, magnetic resonance imaging or ultrasound augment the understanding of complex anatomy and pathology, assist preoperative planning and simulate surgical or interventional procedures to achieve precision medicine for improvement of treatment outcomes, train young or junior doctors to gain their confidence in patient management and provide medical education to medical students or healthcare professionals as an effective training tool. This article provides an overview of patient-specific 3D printed models with a focus on the applications in cardiovascular disease including: 3D printed models in congenital heart disease, coronary artery disease, pulmonary embolism, aortic aneurysm and aortic dissection, and aortic valvular disease. Clinical value of the patient-specific 3D printed models in these areas is presented based on the current literature, while limitations and future research in 3D printing including bioprinting of cardiovascular disease are highlighted.

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Section: D Printing In Aortic Aneurysm and Aortic Dissectionmentioning

confidence: 83%

Section: D Printing In Aortic Aneurysm and Aortic Dissectionmentioning

confidence: 99%

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Sun

2020

Biomolecules

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“…A set of catheters and guidewires were tested, and the most appropriate were selected for the real procedure. A similar simulation was carried out on the aorta to test the possibility of crossing unfavorable anatomy [10]. Based on the simulation, the operative plan was altered.…”

Section: Discussionmentioning

confidence: 99%

Simulation and Training of Needle Puncture Procedure with a Patient-Specific 3D Printed Gluteal Artery Model

Rynio

Falkowski

Witowski

et al. 2020

JCM

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The puncture of the gluteal artery (GA) is a rare and difficult procedure. Less experienced clinicians do not always have the opportunity to practice and prepare for it, which creates a need for novel training tools. We aimed to investigate the feasibility of developing a 3D-printed, patient-specific phantom of the GA and its surrounding tissues to determine the extent to which the model can be used as an aid in needle puncture planning, simulation, and training. Computed tomography angiography scans of a patient with an endoleak to an internal iliac artery aneurysm with no intravascular antegrade access were processed. The arterial system, including the superior GA with its division branches, and pelvic area bones were 3D printed. The 3D model was embedded in the buttocks-shaped, patient-specific mold and cast. The manufactured, life-sized phantom was used to simulate the GA puncture procedure and was validated by 13 endovascular specialists. The printed GA was visible in the fluoroscopy, allowing for a needle puncture procedure simulation. The contrast medium was administered, simulating a digital subtraction angiography. Participating doctors suggested that the model could make a significant impact on preprocedural planning and resident training programs. Although the results are promising, we recommend that further studies be used to adjust the design and assess its clinical value.

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“…by Arch Branch Endovascular Graft from Cook Medical, Brisbane, Australia), the procedure described using PMEG is feasible [ 7 , 8 ]. Such grafts could be planned on the basis of computed tomography angiography (CTA), and use of a 3D printing template ensures optimal graft modification [ 9 , 10 ]. The 3D model also helps to predict problems with the introduction of the delivery system to the arch and the ascending aorta [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

Jędrzejczak¹,

Rynio²,

Lewandowski³

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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An externalized transapical guidewire (ETAG) technique has been used for safe delivery of high-profile devices through a tortuous aorta to zone 0, which is currently precluded after mechanical artificial aortic valve replacement (AVR). The aim of the study was to report one center’s experience (based on 3 cases) of a unique modification to the ETAG technique used for the first time during total endovascular aortic arch repair after AVR. This report contains technical notes regarding a new method of steering the guidewire from the apex inside the artificial aortic valve during total endovascular aortic arch repair after AVR and the details crucial in preparation for this mini-invasive procedure. As a conclusion, the ETAG technique could be performed after mechanical AVR with active positioning of the guidewire carried out under the control of transesophageal echocardiography.

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A 3D Printed Aortic Arch Template to Facilitate Decision-Making Regarding the Use of an Externalized Transapical Wire during Thoracic Endovascular Aneurysm Repair

Cited by 14 publications

References 9 publications

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

Simulation and Training of Needle Puncture Procedure with a Patient-Specific 3D Printed Gluteal Artery Model

Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

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