Tailor-made shaping of microcatheters using three-dimensional printed vessel models for endovascular coil embolization

Ishibashi, Toshiyuki; Takao, Hiroyuki; Suzuki, Takashi; Yuki, Ichiro; Kaku, Shogo; Kan, Issei; Nishimura, Kazuhiko; Suzuki, Tomoaki; Watanabe, Motoi; Karagiozov, Kostadin; Murayama, Yuichi

doi:10.1016/j.compbiomed.2016.07.005

Cited by 41 publications

(36 citation statements)

References 3 publications

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“…First, the 2D computer screen lacks in-depth information, so the surgeon cannot make accurate spatial assessments of the 3D structure and position. Second, it is difficult for the surgeon to accurately determine the true path of the microcatheter into the parent artery and has to depend on experience 10…”

Section: Discussionmentioning

confidence: 99%

“…The same standards were used for everyone. Two senior professors in neurointervention used ’good' and ’poor' to evaluate the accessibility, the in-position condition and stability, recorded whether re-shaping was needed,10 whether stent-assistance or other techniques were necessary, and evaluated other indicators such as aneurysm embolization rate and intraoperative complications. Prognostic assessment MRSModified Rankin Scale) was performed 3 months after surgery.…”

Section: Intraoperative Model Use and Evaluationmentioning

confidence: 99%

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Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

Tian

Zhao

et al. 2019

J NeuroIntervent Surg

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Background and purposeMicrocatheterization is an important, but also difficult, technique used for the embolization of intracranial aneurysms. The purpose of this study was to investigate the application of three-dimensional (3D) printing technology in microcatheter shaping.MethodsNine cases of internal carotid artery posterior communicating artery aneurysm diagnosed by CT angiography were selected, and 3D printing technology was used to build a 3D model including the aneurysm and the parent artery. The hollow and translucent model had certain flexibility; it was immersed in water and the microcatheter was introduced into the water to the target position in the aneurysm, followed by heating the water temperature to 50°C. After soaking for 5 min, the microcatheter was taken out and the shaping was completed. After sterilization, the shaped microcatheter was used for arterial aneurysm embolization and evaluation was conducted.ResultsNine cases of microcatheter shaping were satisfactory and shaping the needle was not necessary; no rebound was observed. The microcatheter was placed in an ideal position, and the stent-assisted method was used in three cases of wide-neck aneurysm. There were no complications related to surgery.ConclusionA new microcatheter shaping method using 3D printing technology makes intracranial artery aneurysm embolization more stable and efficient.

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Section: Discussionmentioning

confidence: 99%

Section: Intraoperative Model Use and Evaluationmentioning

confidence: 99%

Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

Tian

Zhao

et al. 2019

J NeuroIntervent Surg

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“…In fact, the majority of these studies have compared the preplanned procedure to the actual surgery for aneurysm clip- Similar strategy performed in the actual surgery; strategy (e.g., more clips) usually changed because of hard wall or wide-necked lesion ping 7,9,10,19,21,22 and endovascular management; these studies have mainly assessed microcatheter vascular access or endosaccular embolization. 6,8,13 In general, the results of the above studies suggest that the preplanned strategy is usually performed in the actual procedure and the benefits are perceived by the operator, however, there is no consensus on how to objectively measure outcomes after simulation and there is no prediction of the long-term outcome for the patient. Also, in some instances such as aneurysm rupture, it is futile to consider performing a surgical simulation.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional printing and neuroendovascular simulation for the treatment of a pediatric intracranial aneurysm: case report

Sullivan¹,

Aguilar‐Salinas²,

Santos³

et al. 2018

Journal of Neurosurgery: Pediatrics

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The use of simulators has been described in a variety of fields as a training tool to gain technical skills through repeating and rehearsing procedures in a safe environment. In cerebrovascular surgery, simulation of skull base approaches has been used for decades. The use of simulation in neurointervention to acquire and enhance skills before treating a patient is a newer concept, but its utilization has been limited due to the lack of good models and deficient haptics. The advent of 3D printing technology and the development of new training models has changed this landscape. The prevalence of aneurysms in the pediatric population is much lower than in adults, and concepts and tools sometimes have to be adapted from one population to another. Neuroendovascular rehearsal is a valid strategy for the treatment of complex aneurysms, especially for the pediatric population. The authors present the case of an 8-year-old boy with a fusiform intracranial aneurysm and documented progressive growth, who was successfully treated after the authors rehearsed the placement of a flow diverter using a patient-specific 3D-printed replicator system model.

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“…Furthermore, a learning effect might have taken place as the operators become used to the anatomy over time. We have not yet tested custom-shaped catheters12 as this might also influence the operators’ technique. In our opinion, our model is well suited to compare the use of custom-shaped catheters with standard shapes.…”

Section: Discussionmentioning

confidence: 99%

A new method to statistically describe microcatheter tip position in patient-specific aneurysm models

Nawka

Buhk

Gellißen

et al. 2018

J NeuroIntervent Surg

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Background and purposeEvidence on how to select microcatheters to facilitate aneurysm catheterization during coil embolization is sparse. We developed a new method to define microcatheter tip location inside a patient-specific aneurysm model as a 3-dimensional probability map. We hypothesized that precision and accuracy of microcatheter tip positioning depend on catheter tip shape and aneurysmal geometry.Materials and methodsUnder fluoroscopic guidance two to three operators introduced differently shaped microcatheters (straight, 45°, 90°) into eight aneurysm models targeting the anatomic center of the aneurysm. Each microcatheter position was recorded with flat-panel CT, and 3-dimensional probability maps of the microcatheter tip positions were generated. Maps were assessed with histogram analyses and compared between tip shapes, aneurysm locations and operators.ResultsAmong a total of 530 microcatheter insertions, the precision (mean distance between catheter positions) and accuracy (mean distance to target position) were significantly higher for the 45° tip (1.10±0.64 mm, 3.81±1.41 mm, respectively) than for the 90° tip (1.27±0.57 mm, p=0.010; 4.21±1.60 mm p=0.014, respectively). Accuracy was significantly higher in posterior communicating artery aneurysms (3.38±1.20 mm) than in aneurysms of the internal carotid artery (4.56±1.54 mm, p<0.001).ConclusionOur method can be used tostatistically describe statistically microcatheter behavior in patient-specific anatomy, which may improve the available evidence guiding microcatheter shape selection. Experience increases the ability to reach the intended position with a microcatheter (accuracy) that is also dependent on the aneurysm location, whereas catheter tip choice determines the variability of catheter tip placements versus each other (precision). Clinical validation is required.

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Tailor-made shaping of microcatheters using three-dimensional printed vessel models for endovascular coil embolization

Abstract: Tailor-made shaping of microcatheters may facilitate easier and safer procedures in coil embolization of intracranial aneurysm.

Cited by 41 publications

References 3 publications

Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

Microcatheter shaping using three-dimensional printed models for intracranial aneurysm coiling

Three-dimensional printing and neuroendovascular simulation for the treatment of a pediatric intracranial aneurysm: case report

A new method to statistically describe microcatheter tip position in patient-specific aneurysm models

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