Three-dimensional printing technology for treatment of intracranial aneurysm

Yin, Kang; Yu, Long; Xu, Tao; Zheng, Shu-Fa; Yao, Pei-Sen; Liu, Man; Lin, Yuanxiang; Zhang, Lin; Fan, Xiao; Kang, Dezhi

doi:10.1186/s41016-016-0046-3

Cited by 7 publications

(8 citation statements)

References 24 publications

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“…The application of 3D printing in medical treatment is becoming a major area of focus. Currently, 3D-printing technology has been employed in clinical trials for vascular interventions, anatomical resection of hepatocellular carcinoma, and the treatment of intracranial aneurysms [24][25][26] . However, there have been very few reports of the use of 3D printing in colon surgery.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery

Chen

Bian

Zhou

et al. 2020

Sci Rep

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The anatomy of the superior mesenteric vessels is complex, yet important, for right-sided colorectal surgery. The usefulness of three-dimensional (3D) printing of these vessels in right hemicolon cancer surgery has rarely been reported. In this prospective clinical study, 61 patients who received laparoscopic surgery for right hemicolon cancer were preoperatively randomized into 3 groups: 3D-printing (20 patients), 3D-image (19 patients), and control (22 patients) groups. Surgery duration, bleeding volume, and number of lymph node dissections were designed to be the primary end points, whereas postoperative complications, post-operative flatus recovery time, duration of hospitalization, patient satisfaction, and medical expenses were designed to be secondary end points. To reduce the influence of including different surgeons in the study, the surgical team was divided into 2 groups based on surgical experience. The duration of surgery for the 3D-printing and 3D-image groups was significantly reduced (138.4 ± 19.5 and 154.7 ± 25.9 min vs. 177.6 ± 24.4 min, P = 0.000 and P = 0.006), while the number of lymph node dissections for the these 2 groups was significantly increased (19.1 ± 3.8 and 17.6 ± 3.9 vs. 15.8 ± 3.0, P = 0.001 and P = 0.024) compared to the control group. Meanwhile, the bleeding volume for the 3D-printing group was significantly reduced compared to the control group (75.8 ± 30.4 mL vs. 120.9 ± 39.1 mL, P = 0.000). Moreover, patients in the 3D-printing group reported increased satisfaction in terms of effective communication compared to those in the 3D-image and control groups. Medical expenses decreased by 6.74% after the use of 3D-printing technology. Our results show that 3D-printing technology could reduce the duration of surgery and total bleeding volume and increase the number of lymph node dissections. 3D-printing technology may be more helpful for novice surgeons. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017161. Registered on 15 July 2018. With the introduction of the concept of complete mesocolic excision (CME), lymph node dissection in laparoscopic surgery has become more standardized, and the effect of surgical treatment on colon cancer has improved 1,2. However, CME is a challenging procedure for the surgeon 3. Indeed, CME surgery for right colon cancer requires clear dissection of the superior mesenteric artery and vein (SMA and SMV) and their branches 4-6. Moreover, the Henle trunk and right colonic and ileocolic artery and vein present important anatomical differences 7-9. This increases the difficulty of the surgery, and, consequently, the time required for a novice surgeon to learn the surgical technique. Therefore, we propose a new method to determine the course of the mesenteric vessels, and devise an appropriate surgical plan prior to the need for surgery.

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Section: Discussionmentioning

confidence: 99%

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery

Chen

Bian

Zhou

et al. 2020

Sci Rep

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“…3D printing model can use the physical model to design the surgical plan, selecting the best surgical method and the appropriate aneurysm clipping. It can also simulates high similarity and personalized design features of the aneurysm [19]; The 3D model facilitates surgical planning, particularly for the design of multiple arterial aneurysm for the preoperative planning and tumor clipping of giant aneurysms, can realize the complex arterial aneurysm with a single custom tumor clipping. In addition, through the fine clamping technique, the selection of tumor clamps and surgical procedures according to the type of tumor neck provides a more safe and feasible treatment strategy for intracranial aneurysms.…”

Section: Discussionmentioning

confidence: 99%

The classification of intracranial aneurysm neck: a single center research experience

Huang

Kang

et al. 2018

Chin Neurosurg Jl

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Background: There is associating with incidence of unfavorable outcomes compared to microsurgical clippings. We are in order to investigate the outcomes of microsurgical clipping for intracranial aneurysms and determine the ideal clipping methods for different aneurysm subtypes.Method: Retrospectively analyzed the clinical characteristics and follow-up data (completely recorded) of 123 patients with 128 aneurysms were treated. 20 cases were treated as control group from , aneurysms were classified base on the 20 cases of aneurysm imaging data. 103 patients were treated as experimental group, the classification of aneurysms previously proposed was used to estimate the way of surgery, and the guiding value of the genotype was verified according to the intraoperative findings. The proposed aneurysm classification is based on the virtual surface of the aneurysm and the parent artery, the aneurysm neck was classified as follows: subtype I, the curved surface of the neck is a single curved surface; subtype II, the neck is hyperboloid; subtype III, neck is a three-curved surface. Aneurysms were divided into further subtypes according to the ratio of the width of the aneurysm neck surface and the length of the artery circumference: subtype A, the ratio of the aneurysm neck surface to the parent artery was not more than 0.5; subtype B, more than 0.5. There are some clamping methods include simple, sliding, interlocking and hybrid.Results: In the control group, patients did not undergo a suitable clipping scheme without classification of aneurysm neck (unclassed clipping). While causing the occurrence of occlusion adverse events, including neck residual, Tumor artery stenosis, electrophysiological changes, the lack of blood supply and so on. The experimental[page1image12073600]group was analyzed by using a predetermined clipping scheme (classed clipping), and the use of aneurysms clamps was approximately the same as expected. Compared the preoperative assessment with the actual situation, the consistency of the control group was 50% and the experimental group was 96%. Adverse events of classed clipping is 2%, another is 60%. There is a significant difference between the two groups (P < 0.05).Classed clipping of subject IA and IB are simple (mean 1.2 and 1.3 clips); classed clipping of subject IIA is simple and interlocking(mean 1.2 clips); classed clipping of subject IIB is sliding and hybrid(mean 2.05 clips); classed clipping of subject IIIA and IIIB are hybrid(mean 2.3 clips). Conclusion: There is a higher consistency in surgery through the above classification of preoperative assessment of clipping. There was no adverse event of intracranial aneurysm clipping in the clipping mode selected by the above classification, and satisfactory surgical clipping rate was achieved and no recurrence was found.

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“…Because of its complexity and the alternative treatments available, neurosurgery trainees today have limited exposure to microsurgery of intracranial aneurysms [1][2][3]. Exposure to aneurysm clipping usually occurs during the advanced phase of a residency program or, for a select group, during a dedicated fellowship [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…3D aneurysm surgical simulators and physical models have been reported, but they lack blood-like flow time resolution and other crucial components like patency, dynamic behavior, haptics, tactility, and feedback for handling micro-surgical tools and clips [2,17]. Existing models to date cannot expose trainees to the entire surgical workflow, which includes indocyanine-green video angiography (ICG) for inspecting aneurysm occlusion [18,19].…”

Section: Introductionmentioning

confidence: 99%

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

et al. 2020

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Background Due to its complexity and to existing treatment alternatives, exposure to intracranial aneurysm microsurgery at the time of neurosurgical residency is limited. The current state of the art includes training methods like assisting in surgeries, operating under supervision, and video training. These approaches are labor-intensive and difficult to fit into a timetable limited by the new work regulations. Existing virtual reality (VR)–based training modules lack patient-specific exercises and haptic properties and are thus inferior to hands-on training sessions and exposure to real surgical procedures. Materials and methods We developed a physical simulator able to reproduce the experience of clipping an intracranial aneurysm based on a patient-specific 3D-printed model of the skull, brain, and arteries. The simulator is made of materials that not only imitate tissue properties including arterial wall patency, thickness, and elasticity but also able to recreate a pulsatile blood flow. A sample group of 25 neurosurgeons and residents (n = 16: early residency with less than 4 years of neurosurgical exposure; n = 9: late residency and board-certified neurosurgeons, 4–15 years of neurosurgical exposure) took part to the study. Participants evaluated the simulator and were asked to answer questions about surgical simulation anatomy, realism, haptics, tactility, and general usage, scored on a 5-point Likert scale. In order to evaluate the feasibility of a future validation study on the role of the simulator in neurosurgical postgraduate training, an expert neurosurgeon assessed participants’ clipping performance and a comparison between groups was done. Results The proposed simulator is reliable and potentially useful for training neurosurgical residents and board-certified neurosurgeons. A large majority of participants (84%) found it a better alternative than conventional neurosurgical training methods. Conclusion The integration of a new surgical simulator including blood circulation and pulsatility should be considered as part of the future armamentarium of postgraduate education aimed to ensure high training standards for current and future generations of neurosurgeons involved in intracranial aneurysm surgery.

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Three-dimensional printing technology for treatment of intracranial aneurysm

Cited by 7 publications

References 24 publications

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery

Usefulness of three-dimensional printing of superior mesenteric vessels in right hemicolon cancer surgery

The classification of intracranial aneurysm neck: a single center research experience

Neurosurgical simulator for training aneurysm microsurgery—a user suitability study involving neurosurgeons and residents

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