Accessing 3D Printed Vascular Phantoms for Procedural Simulation

Abstract

Introduction: 3D printed patient-specific vascular phantoms provide superior anatomical insights for simulating complex endovascular procedures. Currently, lack of exposure to the technology poses a barrier for adoption. We offer an accessible, low-cost guide to producing vascular anatomical models using routine CT angiography, open source software packages and a variety of 3D printing technologies.Methods: Although applicable to all vascular territories, we illustrate our methodology using Abdominal Aortic Aneurysms (AAAs) due to the strong interest in this area. CT aortograms acquired as part of routine care were converted to representative patient-specific 3D models, and then printed using a variety of 3D printing technologies to assess their material suitability as aortic phantoms. Depending on the technology, phantoms cost $20–$1,000 and were produced in 12–48 h. This technique was used to generate hollow 3D printed thoracoabdominal aortas visible under fluoroscopy.Results: 3D printed AAA phantoms were a valuable addition to standard CT angiogram reconstructions in the simulation of complex cases, such as short or very angulated necks, or for positioning fenestrations in juxtarenal aneurysms. Hollow flexible models were particularly useful for device selection and in planning of fenestrated EVAR. In addition, these models have demonstrated utility other settings, such as patient education and engagement, and trainee and anatomical education. Further study is required to establish a material with optimal cost, haptic and fluoroscopic fidelity.Conclusion: We share our experiences and methodology for developing inexpensive 3D printed vascular phantoms which despite material limitations, successfully mimic the procedural challenges encountered during live endovascular surgery. As the technology continues to improve, 3D printed vascular phantoms have the potential to disrupt how endovascular procedures are planned and taught.

RF Remote Blood Glucose Sensor and a Microfluidic Vascular Phantom for Sensor Validation

“…Patient-specific vascular models have been used for surgical training to simulate complex procedures such as endovascular aneurysm repair and coil embolization [ 19 ]. In this work, vascular model of the ulnar artery of humans was translated into a microfluidic device using angiogram images of the hand artery.…”

“… ( a ) Angiogram image of a hand artery from [ 19 ]. Inset: Replica image of hand artery redrawn in Adobe Illustrator.…”

“…Cespedes et al, in his research, tuned his mixture for applications to 5.8 GHz [ 17 ], while Yilmaz et al designed a mixture for broadband applications of 0.3 to 20 GHz [ 18 ]. More accurate patient-specific phantom models can also be developed using synthetic anatomical models with vascular phantoms that are either 3D printed [ 19 ] or fabricated using soft lithography. In this work, we have fabricated microfluidic vascular phantoms in Polydimethylsiloxane (PDMS), which are based on angiogram images of the hand artery to validate the functionality of our sensor with different glucose concentrations.…”

What is Artificial Intelligence Surgery?

“…Another benefit of AI in surgical training is the development of 3-D printing. Researchers have begun creating 3-D printed vascular "phantoms" of aortic aneurysms and then using them to simulate endovascular aneurysm repair with stents pre-operatively [25] . As opposed to having to send images out of institutions to specialized centers for 3-D printing, phantoms can now be printed on-site, thus, enhancing the use and diffusion of this technology.…”

A look to the future: Pandemic-induced digital technologies in vascular surgery

“…Segmentation of 3D datasets facilitates the extraction of specific structures for advanced reconstruction, and 3D printers have been used to create physical models of vascular structures, such as the aorta for education, training, or preoperative planning [112] , including preparation of custom-manufactured or physician-modified endografts in complex endovascular aneurysm repair [113] .…”