ID 11623
File
Authors
Nakajima, Sadao Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University Researchers DB
Sakamoto, Makoto Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University Researchers DB KAKEN
Yoshioka, Hiroki Department of Neurosurgery, Tottori Prefectural Central Hospital Researchers DB
Uno, Tetsuji Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University Researchers DB
Kurosaki, Masamichi Division of Neurosurgery, Department of Brain and Neurosciences, Faculty of Medicine, Tottori University Researchers DB
Keywords
cerebral aneurysm
coil embolization
endovascular surgery
microcatheter shape
stereolithography 3D printer
Abstract
[Background] To perform successful coil embolization of cerebral aneurysms, it is crucial to make an appropriately shaped microcatheter tip for an aneurysm and its parent artery. So far, we manually shaped a mandrel by referencing two-dimensional (2D) images of a rotation digital subtraction angiography (DSA) on a computer screen. However, this technique requires a lot of experience, and often involves trial and error. Recently, there have been increasing reports of manual mandrel shaping using a full-scale three-dimensional (3D) model of an aneurysm and its parent artery output by various types of 3D printer. We have further developed this method by producing a hollow model of an aneurysm and its parent artery with a stereolithography 3D printer and inserting a mandrel inside the model to fit and stabilize a microcatheter tip. [Methods] Based on digital imaging and communications in medicine (DICOM) data obtained by rotational DSA, 3D images of an aneurysm and its parent artery were created and converted into standard triangulated language (STL) data. A hollow model was produced by extruding the STL data outward in the normal direction, and then a hole was made at the tip of the aneurysm using these STL data. We output these STL data to a stereolithography 3D printer. After cleaning and sterilizing the model, the mandrel was inserted in the direction of the parent artery through the hole made in the tip of the aneurysm and pushed in, creating the ideal mandrel shape. Twelve cases (14 aneurysms) were included in this study. A microcatheter tip was shaped by this method for patients who were scheduled to undergo coil embolization for an unruptured aneurysm. [Results] In 13 of the 14 aneurysms, the microcatheter was easily guided into the aneurysms in one or two trials, the position of the microcatheter tip in the aneurysm was appropriate, and the stability during coil embolization was high. [Conclusion] Our method differs from the conventional one in that a hollow model made of resin is produced with a stereolithography 3D printer and that the mandrel is shaped by inserting it retrogradely into the hollow model. Using our new method, it will be possible to shape the tip of a microcatheter suitable for safe and stable coil embolization without relying on an operator’s experience.
Publisher
Tottori University Medical Press
Content Type
Journal Article
Link
ISSN
05135710
EISSN
13468049
NCID
AA00892882
Journal Title
Yonago Acta Medica
Current Journal Title
Yonago Acta Medica
Volume
64
Issue
1
Start Page
113
End Page
119
Published Date
2021-02-22
Publisher-DOI
Text Version
Publisher
Rights
(C) 2021 Tottori University Medical Press
Citation
S. Nakajima, M. Sakamoto, H. Yoshioka, et al. A New Method of Microcatheter Heat-Forming for Cerebral Aneurysmal Coiling Using Stereolithography Three-Dimensional Printed Hollow Vessel Models. Yonago Acta Medica. 2021, 64(1), 113-119. doi:10.33160/yam.2021.02.001
Department
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital
Language
English