scholarly journals Accessing 3D Printed Vascular Phantoms for Procedural Simulation

2021 ◽  
Vol 7 ◽  
Author(s):  
Jasamine Coles-Black ◽  
Damien Bolton ◽  
Jason Chuen
Keyword(s):  
3D Printing ◽  
Endovascular Procedures ◽  
Low Cost ◽  
3D Models ◽  
Routine Care ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Ct Angiogram ◽  
Abdominal Aortic ◽  
3D Printed

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.

scholarly journals A review and guide to creating patient specific 3D printed anatomical models from MRI for benign gynecologic surgery

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Teresa E. Flaxman ◽  
Carly M. Cooke ◽  
Olivier X. Miguel ◽  
Adnan M. Sheikh ◽  
Sukhbir S. Singh
Keyword(s):  
3D Printing ◽  
Clinical Benefit ◽  
Three Dimensional ◽  
Uterine Fibroids ◽  
3D Models ◽  
Gynecologic Surgery ◽  
Patient Specific ◽  
Mr Images ◽  
Adjacent Structures ◽  
3D Printed

Abstract Background Patient specific three-dimensional (3D) models can be derived from two-dimensional medical images, such as magnetic resonance (MR) images. 3D models have been shown to improve anatomical comprehension by providing more accurate assessments of anatomical volumes and better perspectives of structural orientations relative to adjacent structures. The clinical benefit of using patient specific 3D printed models have been highlighted in the fields of orthopaedics, cardiothoracics, and neurosurgery for the purpose of pre-surgical planning. However, reports on the clinical use of 3D printed models in the field of gynecology are limited. Main text This article aims to provide a brief overview of the principles of 3D printing and the steps required to derive patient-specific, anatomically accurate 3D printed models of gynecologic anatomy from MR images. Examples of 3D printed models for uterine fibroids and endometriosis are presented as well as a discussion on the barriers to clinical uptake and the future directions for 3D printing in the field of gynecological surgery. Conclusion Successful gynecologic surgery requires a thorough understanding of the patient’s anatomy and burden of disease. Future use of patient specific 3D printed models is encouraged so the clinical benefit can be better understood and evidence to support their use in standard of care can be provided.

scholarly journals 3D Printing of Rapid, Low-Cost and Patient-Specific Models of Brain Vasculature for Use in Preoperative Planning in Clipping of Intracranial Aneurysms

2021 ◽  
Vol 10 (6) ◽  
pp. 1201
Author(s):  
Maciej Błaszczyk ◽  
Redwan Jabbar ◽  
Bartosz Szmyd ◽  
Maciej Radek
Keyword(s):  
3D Visualization ◽  
Low Cost ◽  
Cost Benefit ◽  
Image Data ◽  
Cost Effective ◽  
3D Models ◽  
Urgent Care ◽  
Patient Specific ◽  
Stl File ◽  
3D Printed

We developed a practical and cost-effective method of production of a 3D-printed model of the arterial Circle of Willis of patients treated because of an intracranial aneurysm. We present and explain the steps necessary to produce a 3D model from medical image data, and express the significant value such models have in patient-specific pre-operative planning as well as education. A Digital Imaging and Communications in Medicine (DICOM) viewer is used to create 3D visualization from a patient’s Computed Tomography Angiography (CTA) images. After generating the reconstruction, we manually remove the anatomical components that we wish to exclude from the print by utilizing tools provided with the imaging software. We then export this 3D reconstructions file into a Standard Triangulation Language (STL) file which is then run through a “Slicer” software to generate a G-code file for the printer. After the print is complete, the supports created during the printing process are removed manually. The 3D-printed models we created were of good accuracy and scale. The median production time used for the models described in this manuscript was 4.4 h (range: 3.9–4.5 h). Models were evaluated by neurosurgical teams at local hospital for quality and practicality for use in urgent and non-urgent care. We hope we have provided readers adequate insight into the equipment and software they would require to quickly produce their own accurate and cost-effective 3D models from CT angiography images. It has become quite clear to us that the cost-benefit ratio in the production of such a simplified model is worthwhile.

scholarly journals The use of three-dimensional anatomical patient-specific printed models in surgical clipping of intracranial aneurysm: A pilot study

2020 ◽  
Vol 11 ◽  
pp. 381
Author(s):  
Moneer K. Faraj ◽  
Samer S. Hoz ◽  
Amjad J. Mohammad
Keyword(s):  
3D Printing ◽  
Teaching Hospital ◽  
Three Dimensional ◽  
3D Models ◽  
Patient Specific ◽  
Anterior Communicating Artery ◽  
Parent Vessel ◽  
Microsurgical Clipping ◽  
Valuable Adjunct ◽  
3D Printed

Background: In the present study, we aim to develop simulation models based on computed tomography angiography images of intracranial aneurysms (IAs) and their parent vessels using three-dimensional (3D) printing technology. The study focuses on the value of these 3D models in presurgical planning and intraoperative navigation and ultimately their impact on patient outcomes. To the best of our knowledge, this is the first report of its kind from a war-torn country, like Iraq. Methods: This is a prospective study of a series of 11, consecutively enrolled, patients suffering from IAs for the period between February and September 2019. The study represents a collaboration between the two major neurosurgical centers in Baghdad/Iraq; Neurosciences Teaching Hospital and Neurosurgery Teaching Hospital. We analyzed the data of eleven patients with IAs treated by microsurgical clipping. These data include patient demographics, clinical, surgical, and outcomes along with the data of the 3D-printed replica used in these surgeries. All cases were operated on by one surgeon. Results: Our study included 11 patients, with a total of 11 aneurysms clipped. The mean age was 44 ± 8, with a median of 42.5 and a range of 35–61 years. About 60% of our patients were female with a female-to-male ratio of 1:5. About 60% of the aneurysms were located at the anterior communicating artery (Acom) while the remaining 40% were equally distributed between the posterior communicating and internal carotid arteries bifurcation. The standard pterional approach was followed in 50% of cases, whereas the other 50% of patients were treated through the lateral supraorbital approach. About 90% (n = 9) of the patients had a Glasgow Outcome Scale (GOS) of 5 and 10% had a GOS of 4. The 3D-printed models successfully replicated the aneurysm size, location, and relation to the parent vessel with 100% accuracy and were used for intraoperative guidance. The average production time was 24–48 h and the production cost was 10–20 US dollars. Conclusion: 3D printing is a promising technology that is rapidly penetrating the field of neurosurgery. In particular, the use of 3D-printed patient-matched, anatomically accurate replicas of the cerebral vascular tree is valuable adjunct to the microsurgical clipping of IAs, and our study conclusions support this concept. However, both the feasibility and clinical utility of 3D printing remain the subject of much, ongoing investigations.

Evaluation of Dimensional Accuracy of 3D printed mandibular model using two different Additive Manufacturing Techniques based on Cone Beam Computed Tomography scan data (A Diagnostic Accuracy Study)

2019 ◽  
Author(s):  
Noha Hamada Mohamed ◽  
Hossam Kandil ◽  
Iman Ismail Dakhli
Keyword(s):  
Additive Manufacturing ◽  
3D Printing ◽  
Low Cost ◽  
Dimensional Accuracy ◽  
3D Models ◽  
The Body ◽  
Reference Standard ◽  
Linear Measurements ◽  
3D Printed ◽  
Manufacturing Techniques

Abstract In dentistry, 3D printing already has diverse applicability, and holds a great deal of promise to make possible many new and exciting treatments and approaches to manufacturing dental restorations. Better availability, shorter processing time, and descending costs have resulted in the increased use of RP. Concomitantly the development of medical applications is expanding. (Zaharia et al., 2017)Many different printing technologies exist, each with their own advantages and disadvantages. Unfortunately, a common feature of the more functional and productive equipment is the high cost of the equipment, the materials, maintenance, and repair, often accompanied by a need for messy cleaning, difficult post-processing, and sometimes onerous health and safety concerns (Dawood et al., 2015)Low-cost 3D printers represent a great opportunity in the dental and medical field, as they could allow surgeons to use 3D models at a very low cost and, therefore, democratize the use of these 3D models in various indications. However, efforts should be made to establish a unified validation protocol for low-cost RP 3D printed models, including accuracy, reproducibility, and repeatability tests. Asaumi et al., suggested that dimensional changes may not affect the success of surgical applications if such changes are within a 2% variation .However, the proposed cut-off of 2% should be furthermore discussed, as the same accuracy may be not required for all types of indications. (Silva et al., 2008; Maschio et al., 2016)This aim of the present study is to evaluate the dimensional accuracy of the 3D printed mandibular models fabricated by two different additive manufacturing techniques, using highly precise one as selective laser sintering (SLS) and a low-cost one as fused filament fabrication and whether they are both comparable in terms of precision. In addition to evaluation of dimensional accuracy of linear measurements of the mandible in CBCT scans.7 mandibular models will be recruited. Radio-opaque markers of gutta-percha balls will be applied on the model to act as guide pointsTen linear measurements (5 long distances: Inter-condylar, inter-coronoidal, inter-mandibular notch, length of left ramus, length of right ramus; as well as 5 short distances: Length of the body of the mandible at midline, length of the body of the mandible in the area of last left molar, as well as that of the last right molar, the distance between the tip of right condyle to the tip of the right coronoid, as well as that of their left counterparts) will be obtained using digital calliper, to act as the reference standard later. Scanning of the model by CBCT will be next , 3D printing of the scanned image using SLS and FFF printers will be done. Recording of same linear measurment will be done on printed models. Comparison of the recorded values vs reference standard is the last step

scholarly journals IP029. Ultrasound Detection of Heterogeneous Accumulated Strain Within 3D Printed Patient Specific Abdominal Aortic Aneurysms

2016 ◽  
Vol 63 (6) ◽  
pp. 65S-66S
Author(s):  
Doran Mix ◽  
Isaac Arabadjis ◽  
Lynn Atene ◽  
Michael Stoner ◽  
Michael Richards
Keyword(s):  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Patient Specific ◽  
Abdominal Aortic ◽  
Accumulated Strain ◽  
3D Printed

scholarly journals In-Hospital 3D Printed Scaphoid Prosthesis Using Medical-Grade Polyetheretherketone (PEEK) Biomaterial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Philipp Honigmann ◽  
Neha Sharma ◽  
Ralf Schumacher ◽  
Jasmine Rueegg ◽  
Mathias Haefeli ◽  
...  
Keyword(s):  
3D Printing ◽  
Point Of Care ◽  
Low Cost ◽  
Three Dimensional ◽  
Patient Specific ◽  
Fused Filament Fabrication ◽  
Patient Specific Implants ◽  
Surgical Guides ◽  
3D Printed ◽  
Medical Grade

Recently, three-dimensional (3D) printing has become increasingly popular in the medical sector for the production of anatomical biomodels, surgical guides, and prosthetics. With the availability of low-cost desktop 3D printers and affordable materials, the in-house or point-of-care manufacturing of biomodels and Class II medical devices has gained considerable attention in personalized medicine. Another projected development in medical 3D printing for personalized treatment is the in-house production of patient-specific implants (PSIs) for partial and total bone replacements made of medical-grade material such as polyetheretherketone (PEEK). We present the first in-hospital 3D printed scaphoid prosthesis using medical-grade PEEK with fused filament fabrication (FFF) 3D printing technology.

scholarly journals Three-dimensional printing versus conventional machining in the creation of a meatal urethral dilator: a cost and mechanical strength analysis

2020 ◽  
Author(s):  
Michael Yue-Cheng Chen ◽  
Jacob Skewes ◽  
Ryan Daley ◽  
Maria Ann Woodruff ◽  
Nicholas John Rukin
Keyword(s):  
3D Printing ◽  
Low Cost ◽  
Three Dimensional ◽  
Patient Specific ◽  
Strength Analysis ◽  
3D Printer ◽  
Fused Deposition ◽  
3D Printed ◽  
The Cost ◽  
Conventional Machining

Abstract Background Three-dimensional (3D) printing is a promising technology in medicine. Low-cost 3D printing options are accessible but the limitations are often poorly understood. We aim to compare fused deposition modelling (FDM), the most common and low cost 3D printing technique, with selective laser sintering (SLS) and conventional machining techniques in manufacturing meatal urethral dilators which were recently removed from the Australian market.Methods A meatal urethral dilator was designed using computer-aided design (CAD). The dilator was 3D printed vertically orientated on a low cost FDM 3D printer in polylactic acid (PLA) and acrylonitrile butadiene styrene (ABS). It was also 3D printed horizontally orientated in ABS on a high-end FDM 3D printer with soluble support material, as well as on a SLS 3D printer in medical nylon. The dilator was also machined in medical stainless steel using a lathe. All dilators were tested mechanically in a custom rig by hanging calibrated weights from the handle until the dilator snapped.Results The horizontally printed ABS dilator experienced failure at a greater load than the vertically printed PLA and ABS dilators respectively (503g vs 283g vs 163g, p < 0.001). The SLS nylon dilator did not fail but began to bend and deformed at around 5,000g of pressure. The steel dilator did not bend even at 10,000g of pressure. The cost per dilator is highest for the steel dilator if assuming a low quantity of five at 98 USD, but this decreases to 30 USD for a quantity of 1000. In contrast, the cost for the SLS dilator is 33 USD for a quantity of five but relatively unchanged at 27 for a quantity of 1000.Conclusions SLS and conventional machining created clinically functional meatal dilators but low-cost FDM printing could not. We suggest that at the current time 3D printing is not a replacement for conventional manufacturing techniques which are still the most reliable way to produce large quantities of parts with a simple geometry such as the meatal dilator. 3D printing is best used for patient-specific parts, prototyping or manufacturing complex parts that have additional functionality that cannot be achieved with conventional machining methods.

scholarly journals Point-of-care 3D printing: a low-cost approach to teaching carotid artery stenting

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Pieter De Backer ◽  
Charlotte Allaeys ◽  
Charlotte Debbaut ◽  
Roel Beelen
Keyword(s):  
Patient Education ◽  
3D Printing ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
3D Model ◽  
Low Cost ◽  
Patient Specific ◽  
Stent Deployment ◽  
Invasive Approach ◽  
3D Printed

Abstract Background Carotid Artery Stenting (CAS) is increasingly being used in selected patients as a minimal invasive approach to carotid endarterectomy. Despite the long standing tradition of endovascular treatments, visual feedback during stent-deployment is impossible to obtain as deployment is performed under fluoroscopic imaging. Furthermore, the concept of stent-placement is often still unclear to patients. 3D Printing allows to replicate patient-specific anatomies and deploy stents inside them to simulate procedures. As such these models are being used for endovascular training as well as patient education. Purpose To our knowledge, this study reports the first use of a low-cost patient-specific 3D printed model for teaching CAS deployment under direct visualization, without fluoroscopy. Methodology A CT-angiogram was segmented and converted to STL format using Mimics inPrint™ software. The carotid arteries were bilaterally truncated to fit the whole model on a Formlabs 2 printer without omitting the internal vessel diameter. Next, this model was offset using a 1 mm margin. A ridge was modelled on the original vessel anatomy which was subsequently subtracted from the offset model in order to obtain a deroofed 3D model. All vessels were truncated to facilitate post-processing, flow and guide wire placement. Results Carotid artery stents were successfully deployed inside the vessel. The deroofing allows for clear visualization of the bottlenecks and characteristics of CAS deployment and positioning, including stent foreshortening, tapering and recoil. This low-cost 3D model provides visual insights in stent deployment and positioning, and can allow for patient-specific procedure planning. Conclusions The presented approach demonstrates the use of low-cost 3D Printed CAS models in teaching complex stent behavior as observed during deployment. Two main findings are illustrated. On one hand, the feasibility of low-cost in-hospital model production is shown. On the other hand, the teaching of CAS deployment bottlenecks at the carotid level without the need for fluoroscopic guidance, is illustrated. The observed stent characteristics as shown during deployment are difficult to assess in radiologic models. Furthermore, printing patient-specific 3D models preoperatively could possibly assist in accurate patient selection, preoperative planning, case-specific training and patient education.

Development of a patients-specific 3D-printed preoperative planning and training tool, with functionalized internal surfaces, for complex oncologic cases

2019 ◽  
Vol 25 (2) ◽  
pp. 363-377 ◽  
Author(s):  
Asier Muguruza Blanco ◽  
Lucas Krauel ◽  
Felip Fenollosa Artés
Keyword(s):  
3D Printing ◽  
Preoperative Planning ◽  
Low Cost ◽  
Hepatic Metastases ◽  
Value Added ◽  
3D Models ◽  
Anatomical Models ◽  
Anatomical Model ◽  
Content Type ◽  
3D Printed

Purpose The use of physical 3D models has been used in the industry for a while, fulfilling the function of prototypes in the majority of cases where the designers, engineers and manufacturers optimize their designs before taking them into production. In recent years, there has been an increasing number of reports on the use of 3D models in medicine for preoperative planning. In some highly complex surgeries, the possibility of using printed models to previously perform operations can be determining in the success of the surgery. With the aim of providing new functionalities to an anatomical 3D-printed models, in this paper, a cost-effective manufacturing process has been developed. A set of tradition of traditional techniques have been combined with 3D printing to provide a maximum geometrical freedom to the process. By the use of an electroluminescent set of functional paints, the tumours and vessels of the anatomical printed model have been highlighted, providing to this models the possibility to increase its interaction with the surgeon. These set of techniques has been used to increase the value added to the reproduced element and reducing the costs of the printed model, thus making it more accessible. Design/methodology/approach Successfully case in where the use of a low-cost 3D-printed anatomical model was used as a tool for preoperative planning for a complex oncological surgery. The said model of a 70-year-old female patient with hepatic metastases was functionalized with the aim of increasing the interaction with the surgeons. The analysis of the construction process of the anatomical model based on the 3D printing as a tool for their use in the medical field has been made, as well as its cost. Findings The use of 3D printing in the construction of anatomical models as preoperative tools is relatively new; however, the functionalization of these tools by using conductive and electroluminescent materials with the aim of increasing the interaction with it by the surgeons is a novelty. And, based on the DIY principles, it offers a geographical limitlessness, reducing its cost without losing the added value. Originality/value The process based on 3D printing presented in this paper allows to reproduce low-cost anatomical models by following a simple sequence of steps. It can be done by people with low qualification anywhere with only access to the internet and with the local costs. The interaction of these models with the surgeon based on touch and sight is much higher, adding a very significant value it, without increasing its cost.

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