3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

Meess, Karen M; Izzo, Richard L.; Dryjski, Maciej L.; Curl, Richard; Harris, Linda M.; Springer, Michael; Siddiqui, Adnan H.; Rudin, Stephen; Ionita, Ciprian N.

doi:10.1117/12.2253902

Cited by 45 publications

(43 citation statements)

References 28 publications

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“…Researchers have investigated rigid [22] as well as flexible models [23]: rigid phantoms were historically made of glass to allow transparency. Recently, advancements in additive manufacturing techniques-three-dimensional (3D) printing-have permitted rapid fabrication of cost-effective transparent prototypes of patient-specific geometries using rigid materials [20,24].…”

Section: Introductionmentioning

confidence: 99%

“…Though these phantoms are ideal for flow visualization studies, the absence of compliance of the vessel walls does not allow to closely mimic the physiological behavior of anatomical structures leading to inaccuracy of fluid dynamic quantities [25] and failing to reproduce conditions in which devices are deployed. These shortcomings limit their application in clinical training [22]. 3D printers such as the Objet500 Connex3 printer by Stratasys, Inc., (Rehovot, Israel) allow to build layers of compliant rubber-like materials such as TangoPlus [26].…”

Section: Introductionmentioning

confidence: 99%

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Patient-Specific Aortic Phantom With Tunable Compliance

Gallarello

Palombi

Annio

et al. 2019

Journal of Engineering and Science in Medical Diagnostics and Therapy

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Validation of computational models using in vitro phantoms is a nontrivial task, especially in the replication of the mechanical properties of the vessel walls, which varies with age and pathophysiological state. In this paper, we present a novel aortic phantom reconstructed from patient-specific data with variable wall compliance that can be tuned without recreating the phantom. The three-dimensional (3D) geometry of an aortic arch was retrieved from a computed tomography angiography scan. A rubber-like silicone phantom was manufactured and connected to a compliance chamber in order to tune its compliance. A lumped resistance was also coupled with the system. The compliance of the aortic arch model was validated using the Young's modulus and characterized further with respect to clinically relevant indicators. The silicone model demonstrates that compliance can be finely tuned with this system under pulsatile flow conditions. The phantom replicated values of compliance in the physiological range. Both, the pressure curves and the asymmetrical behavior of the expansion, are in agreement with the literature. This novel design approach allows obtaining for the first time a phantom with tunable compliance. Vascular phantoms designed and developed with the methodology proposed in this paper have high potential to be used in diverse conditions. Applications include training of physicians, pre-operative trials for complex interventions, testing of medical devices for cardiovascular diseases (CVDs), and comparative Magnetic-resonance-imaging (MRI)-based computational studies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Patient-Specific Aortic Phantom With Tunable Compliance

Gallarello

Palombi

Annio

et al. 2019

Journal of Engineering and Science in Medical Diagnostics and Therapy

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“…After building the bracket point cloud, in order to restore the mesh structure of the bracket, we also need to manually connect the bracket columns to construct the spatial structure of the biological absorbable stent in the vascular cavity. According to the prior information, we know that the bracket is made up of annular structures, each of which is connected by a scaffold [17,18]. According to the observation, we found that the distance of every 3 to 4 OCTframes is the thickness of a mesh bracket ring, and the structure of the stent-ring can be generated by sequentially connecting the point cloud of the stent column in the adjacent 3 to 4 frames of IVOCT by a curve.…”

Section: Stepmentioning

confidence: 99%

Patient‐Specific Coronary Artery 3D Printing Based on Intravascular Optical Coherence Tomography and Coronary Angiography

et al. 2019

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Despite the new ideas were inspired in medical treatment by the rapid advancement of three-dimensional (3D) printing technology, there is still rare research work reported on 3D printing of coronary arteries being documented in the literature. In this work, the application value of 3D printing technology in the treatment of cardiovascular diseases has been explored via comparison study between the 3D printed vascular solid model and the computer aided design (CAD) model. In this paper, a new framework is proposed to achieve a 3D printing vascular model with high simulation. e patient-speci c 3D reconstruction of the coronary arteries is performed by the detailed morphological information abstracted from the contour of the vessel lumen. In the process of reconstruction which has 5 steps, the morphological details of the contour view of the vessel lumen are merged along with the curvature and length information provided by the coronary angiography. After comparing with the diameter of the narrow section and the diameter of the normal section in CAD models and 3D printing model, it can be concluded that there is a high correlation between the diameter of vascular stenosis measured in 3D printing models and computer aided design models. e 3D printing model has high-modeling ability and high precision, which can represent the original coronary artery appearance accurately. It can be adapted for prevascularization planning to support doctors in determining the surgical procedures.

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“…Three-dimensional printing (3DP) offers a unique opportunity to build geometrically accurate patient-specific vascular phantoms that can be used for device testing [1,2], treatment planning [3], resident physician training [4] and physiological simulations [5,6]. Recent literature has highlighted the advancements in additive and subtractive manufacturing that allow physicians to train and plan for procedures using patient specific phantoms [6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Method to simulate distal flow resistance in coronary arteries in 3D printed patient specific coronary models

et al. 2020

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Background: Three-dimensional printing (3DP) offers a unique opportunity to build flexible vascular patient-specific coronary models for device testing, treatment planning, and physiological simulations. By optimizing the 3DP design to replicate the geometrical and mechanical properties of healthy and diseased arteries, we may improve the relevance of using such models to simulate the hemodynamics of coronary disease. We developed a method to build 3DP patient specific coronary phantoms, which maintain a significant part of the coronary tree, while preserving geometrical accuracy of the atherosclerotic plaques and allows for an adjustable hydraulic resistance. Methods: Coronary computed tomography angiography (CCTA) data was used within Vitrea (Vital Images, Minnetonka, MN) cardiac analysis application for automatic segmentation of the aortic root, Left Anterior Descending (LAD), Left Circumflex (LCX), Right Coronary Artery (RCA), and calcifications. Stereolithographic (STL) files of the vasculature and calcium were imported into Autodesk Meshmixer for 3D model optimization. A base with three chambers was built and interfaced with the phantom to allow fluid collection and independent distal resistance adjustment of the RCA, LAD and LCX and branching arteries. For the 3DP we used Agilus for the arterial wall, VeroClear for the base and a Vero blend for the calcifications, respectively. Each chamber outlet allowed interface with catheters of varying lengths and diameters for simulation of hydraulic resistance of both normal and hyperemic coronary flow conditions. To demonstrate the manufacturing approach appropriateness, models were tested in flow experiments. Results: Models were used successfully in flow experiments to simulate normal and hyperemic flow conditions. The inherent mean resistance of the chamber for the LAD, LCX, and RCA, were 1671, 1820, and 591 (dynes • sec/ cm 5), respectively. This was negligible when compared with estimates in humans, with the chamber resistance equating to 0.65-5.86%, 1.23-6.86%, and 0.05-1.67% of the coronary resistance for the LAD, LCX, and RCA, respectively at varying flow rates and activity states. Therefore, the chamber served as a means to simulate the compliance of the distal coronary trees and to allow facile coupling with a set of known resistance catheters to simulate various physical activity levels.

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3D printed abdominal aortic aneurysm phantom for image guided surgical planning with a patient specific fenestrated endovascular graft system

Cited by 45 publications

References 28 publications

Patient-Specific Aortic Phantom With Tunable Compliance

Patient-Specific Aortic Phantom With Tunable Compliance

Patient‐Specific Coronary Artery 3D Printing Based on Intravascular Optical Coherence Tomography and Coronary Angiography

Method to simulate distal flow resistance in coronary arteries in 3D printed patient specific coronary models

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