Customized vascular models for optimal catheter decision-making: Two aneurysm embolization instances illustrated
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A female patient in her 40s, presenting with a 5 × 5 mm saccular aneurysm at the origin of the dorsal pancreatic artery, branching from the SMA, has benefited from the use of patient-specific vascular models in preoperative planning.
The simulation using the patient-specific vascular model was instrumental in determining the optimal catheter shape for successful treatment in this case. Transparent, flexible, and highly slippery patient-specific hollow vascular models accurately replicate patient-specific vascular anatomy and mechanical conditions, enhancing clinicians' ability to plan and execute interventions precisely.
Coil embolization of peripheral aneurysms in the trunk region requires sufficient catheter stability and precise placement of an appropriate catheter in the primary branch of the aorta. In this case, a 4.5-Fr guiding sheath (Parent Plus45 shepherd hook type) and a 4-Fr Roesch hepatic catheter were determined to provide sufficient backup support for accurate coil placement.
The use of such models allows realistic simulation of catheter navigation and device deployment within anatomically accurate replicas, helping identify the best catheter type and approach strategy before the actual procedure. Their transparency facilitates clear visualization of catheter movement and coil placement, while flexibility and slipperiness mimic the biomechanical properties of actual vessels, enabling better procedural rehearsal under near-physiologic conditions.
The vascular models were created using MeshMixer, PreForm software, and a Form 3L 3D printer with flexible, transparent materials. Preoperative computed tomography (CT) imaging often fails to provide adequate information to determine whether the chosen catheter shape will be compatible with the primary branch originating from the aorta.
In Interventional Radiology, most existing models either lack hollow structures or are small-scale hollow models that fail to reproduce the extended access route from the femoral, radial, or brachial arteries. The vascular models developed for this case were coated with silicone and connected to a sheath in a white box to simulate endovascular procedures without fluoroscopy.
The simulation process reduced the need for catheter replacement, shortened the time required for catheter engagement and placement, and minimized intimal damage risk during the actual procedure. Coil embolization was performed with 2.4/2.6-Fr Leonis Mova and detachable coils, and the procedure was completed successfully with no complications.
This study reports 2 anatomically complex cases of peripheral aneurysms in which preoperative simulations using the developed model were performed to select the optimal catheter shape for successful treatment. Related case reports and studies indicate the immense value of patient-specific modeling and simulation (including 3D printing and computational fluid dynamics) for complex cardiovascular interventions.
Though the exact direct study on this topic from the provided search results is limited, these demonstrations support the concept that flexible, patient-specific vascular models could improve procedural outcomes through tailored catheter selection and preoperative practice.
- In the realm of health-and-wellness, advancements in interventional radiology, such as patient-specific vascular models, are revolutionizing the treatment of medical-conditions like peripheral aneurysms.
- The utilization of these patient-specific models not only enhances preoperative planning but also aids in fitness-and-exercise routines, as they provide realistic simulations of catheter navigation and device deployment, replicating the biomechanical properties of actual vessels.
- By promoting cardiovascular-health through precise interventions, these models contribute to overall health-and-wellness, demonstrating the profound impact of science and technology on modern medicine.
