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首页> 外文会议>Medical Imaging 2017 : Imaging Informatics for Healthcare, Research, and Applications >3D Printed Abdominal Aortic Aneurysm Phantom for Image Guided Surgical Planning with a Patient Specific Fenestrated Endovascular Graft System
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3D Printed Abdominal Aortic Aneurysm Phantom for Image Guided Surgical Planning with a Patient Specific Fenestrated Endovascular Graft System

机译：3D打印的腹主动脉瘤幻影用于图像引导的手术计划，并配有患者特有的有心血管内移植系统

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摘要

Following new trends in precision medicine, Juxatarenal Abdominal Aortic Aneurysm (JAAA) treatment has been enabled by using patient-specific fenestrated endovascular grafts. The X-ray guided procedure requires precise orientation of multiple modular endografts within the arteries confirmed via radiopaque markers. Patient-specific 3D printed phantoms could familiarize physicians with complex procedures and new devices in a risk-free simulation environment to avoid periprocedural complications and improve training. Using the Vascular Modeling Toolkit (VMTK), 3D Data from a CTA imaging of a patient scheduled for Fenestrated EndoVascular Aortic Repair (FEVAR) was segmented to isolate the aortic lumen, thrombus, and calcifications. A stereolithographic mesh (STL) was generated and then modified in Autodesk MeshMixer for fabrication via a Stratasys Eden 260 printer in a flexible photopolymer to simulate arterial compliance. Fluoroscopic guided simulation of the patient-specific FEVAR procedure was performed by interventionists using all demonstration endografts and accessory devices. Analysis compared treatment strategy between the planned procedure, the simulation procedure, and the patient procedure using a derived scoring scheme. Results: With training on the patient-specific 3D printed AAA phantom, the clinical team optimized their procedural strategy. Anatomical landmarks and all devices were visible under x-ray during the simulation mimicking the clinical environment. The actual patient procedure went without complications. Conclusions: With advances in 3D printing, fabrication of patient specific AAA phantoms is possible. Simulation with 3D printed phantoms shows potential to inform clinical interventional procedures in addition to CTA diagnostic imaging.
机译：随着精密医学的新趋势，已通过使用针对患者的开窗有孔血管内移植物来实现近肾上腹主动脉瘤（JAAA）治疗。 X射线引导手术需要通过不透射线标记物在动脉内精确定位多个模块化内移植物。特定于患者的3D打印体模可以使医生熟悉无风险的模拟环境中的复杂程序和新设备，从而避免手术过程中出现并发症并改善培训。使用血管建模工具包（VMTK），对计划进行有条件的内腔主动脉修复（FEVAR）的患者的CTA成像的3D数据进行了分割，以分离出主动脉腔，血栓和钙化。生成了立体光刻网格（STL），然后在Autodesk MeshMixer中对其进行了修改，以通过Stratasys Eden 260打印机在柔性光敏聚合物中进行制造，以模拟动脉顺应性。介入医师使用所有示范性的内移植物和辅助设备对患者的FEVAR程序进行了荧光镜引导下的模拟。分析使用导出的评分方案比较了计划的程序，模拟程序和患者程序之间的治疗策略。结果：通过对患者专用的3D打印AAA幻象的培训，临床团队优化了他们的手术策略。在模拟临床环境的模拟过程中，解剖标志物和所有设备在X射线下均可见。实际的患者手术没有并发症。结论：随着3D打印技术的进步，可以制造患者专用的AAA体模。使用3D打印体模进行仿真显示，除了CTA诊断成像外，还具有为临床干预程序提供信息的潜力。

著录项

  • 来源
  • 会议地点 Orlando(US)
  • 作者

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

  • 作者单位

    The Jacobs Institute, Buffalo, NY 14203,CUBRC Inc., Buffalo, NY 14225,Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228,Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14203;

    The Jacobs Institute, Buffalo, NY 14203,Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228,Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14203;

    Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203;

    Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203;

    Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203;

    The Jacobs Institute, Buffalo, NY 14203;

    The Jacobs Institute, Buffalo, NY 14203,Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14203,Department of Vascular Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203;

    Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228,Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14203,Department of Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203,Department of Radiology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 14203;

    Department of Biomedical Engineering, University at Buffalo, Buffalo, NY 14228,Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY 14203;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

    Abdominal Aortic Aneurysm (AAA); 3D Printing; Image Guided Intervention; Fenestrated EndoVascular Aortic Repair (FEVAR); Image Segmentation; Image Guided Procedure; Surgical Planning;

    机译：腹主动脉瘤（AAA）; 3D打印图像引导干预；有条件的血管内主动脉修复术（FEVAR）；图像分割图像引导程序；手术计划;

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