J. Coles-Black1, J. Chuen1 1Austin Health,Department Of Surgery,Heidelberg, VICTORIA, Australia
Introduction:
There has been strong interest in the application of 3D printing to Vascular Surgery. However, consistently major barriers to uptake include the lack of technical expertise amongst surgeons, and the perceived cost of 3D printing technologies. We present a low-cost, low-complexity, easily reproducible CT-to-3D-printed-model workflow developed using open source software packages and inexpensive desktop 3D-printers.
Methods:
Using 3D Slicer (version 4.5; Harvard, US, 2015), abdominal CT aortogram DICOM datasets were automatically segmented using the "Threshold" function. The "Dilate" and “Subtract Scalar Volume” functions were used to generate a 3D hollow vessel. The mural thrombus was isolated using the "Volume Clip" extension. This was subtracted from the luminal contents in order to create a non-intersecting thrombus model. The model was printed on a Filament Fused Deposition Modelling 3D Printer (Makerbot Replicator 2X; Stratasys, Minnesota, USA). The subsequent 3D printed model was shown to experienced vascular surgeons, who rated its utility for the preoperative planning of complex cases.
Results:
The model was well received, with immediate requests for more models. Manual inspection of the physical model was felt to be a valuable addition to standard CT angiogram reconstructions, especially in tortuous or complex aortic aneurysms. Hollow flexible models were deemed particularly useful for rehearsal of endograft insertion and positioning via the iliac arteries, and in predicting the trajectory of guidewires and devices.
Conclusion:
There are clear applications for 3D printing in the field of Vascular Surgery, with positive feedback from the assessed cohort of experienced surgeons that the AAA models would be useful in challenging cases.
