Efficacy of 3D-printed Simulation Models of Unruptured Intracranial Aneurysms in Patient Education and Surgical Simulation

Overview

Journal J Cerebrovasc Endovasc Neurosurg

Date 2022 Oct 19

PMID 36259163

Authors

Seung-Bin Woo

Chang-Young Lee

Chang-Hyun Kim

Min-Yong Kwon

Young San Ko

Jong-Ha Lee

Jin-Chul Heo

Sae Min Kwon

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of this study was to determine the efficacy of a 3D-printed aneurysm simulation model (3DPM) in educating patients and improving physicians' comprehension and performance.

Methods: This prospective study involved 40 patients who were diagnosed with unruptured intracranial aneurysms (UIAs) and scheduled for surgical clipping or endovascular coiling and randomly divided into two groups (the 3DPM group and the non-3DPM group). The 3DPM was used in preoperative consultation with patients and intraoperatively referenced by surgeons. The patients, 7 neurosurgical residents, and 10 surgeons completed questionnaires (5-point Likert scale) to determine the usefulness of the 3DPM.

Results: Patients in the 3DPM group had significantly higher scores in terms of their understanding of the disease (mean 4.85 vs. 3.95, p<0.001) and the treatment plan (mean 4.85 vs. 4.20, p=0.005) and reported higher satisfaction during consultation (5.0 vs. 4.60, p=0.036) than patients in the non-3DPM group. During patient consultation, 3DPMs were most useful in improving doctor-patient communication (mean 4.57, range 4-5). During clipping surgery, the models were most useful in assessing adjacent arteries (mean 4.9, range 4-5); during endovascular coiling, they were especially helpful in microcatheter shaping (mean 4.7, range 4-5).

Conclusions: In general, 3DPMs are beneficial in educating patients and improving the physician's performance in terms of surgical clipping and endovascular coiling of UIAs.

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References

Vlak M, Algra A, Brandenburg R, Rinkel G . Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: a systematic review and meta-analysis. Lancet Neurol. 2011; 10(7):626-36. DOI: 10.1016/S1474-4422(11)70109-0. View

Chen C, Cai L, Zheng W, Wang J, Guo X, Chen H . The efficacy of using 3D printing models in the treatment of fractures: a randomised clinical trial. BMC Musculoskelet Disord. 2019; 20(1):65. PMC: 6368738. DOI: 10.1186/s12891-019-2448-9. View

Namba K, Higaki A, Kaneko N, Mashiko T, Nemoto S, Watanabe E . Microcatheter Shaping for Intracranial Aneurysm Coiling Using the 3-Dimensional Printing Rapid Prototyping Technology: Preliminary Result in the First 10 Consecutive Cases. World Neurosurg. 2015; 84(1):178-86. DOI: 10.1016/j.wneu.2015.03.006. View

Nagassa R, McMenamin P, Adams J, Quayle M, Rosenfeld J . Advanced 3D printed model of middle cerebral artery aneurysms for neurosurgery simulation. 3D Print Med. 2019; 5(1):11. PMC: 6743137. DOI: 10.1186/s41205-019-0048-9. View

Faraj M, Hoz S, Mohammad A . The use of three-dimensional anatomical patient-specific printed models in surgical clipping of intracranial aneurysm: A pilot study. Surg Neurol Int. 2021; 11:381. PMC: 7771404. DOI: 10.25259/SNI_361_2020. View

Ryan J, Almefty K, Nakaji P, Frakes D . Cerebral Aneurysm Clipping Surgery Simulation Using Patient-Specific 3D Printing and Silicone Casting. World Neurosurg. 2016; 88:175-181. DOI: 10.1016/j.wneu.2015.12.102. View

Randazzo M, Pisapia J, Singh N, Thawani J . 3D printing in neurosurgery: A systematic review. Surg Neurol Int. 2016; 7(Suppl 33):S801-S809. PMC: 5122816. DOI: 10.4103/2152-7806.194059. View

Kimura T, Morita A, Nishimura K, Aiyama H, Itoh H, Fukaya S . Simulation of and training for cerebral aneurysm clipping with 3-dimensional models. Neurosurgery. 2009; 65(4):719-25. DOI: 10.1227/01.NEU.0000354350.88899.07. View

Gabriel R, Kim H, Sidney S, McCulloch C, Singh V, Johnston S . Ten-year detection rate of brain arteriovenous malformations in a large, multiethnic, defined population. Stroke. 2009; 41(1):21-6. PMC: 2847493. DOI: 10.1161/STROKEAHA.109.566018. View

10.

Ishibashi T, Takao H, Suzuki T, Yuki I, Kaku S, Kan I . Tailor-made shaping of microcatheters using three-dimensional printed vessel models for endovascular coil embolization. Comput Biol Med. 2016; 77:59-63. DOI: 10.1016/j.compbiomed.2016.07.005. View

11.

Cogswell P, Rischall M, Alexander A, Dickens H, Lanzino G, Morris J . Intracranial vasculature 3D printing: review of techniques and manufacturing processes to inform clinical practice. 3D Print Med. 2020; 6(1):18. PMC: 7409717. DOI: 10.1186/s41205-020-00071-8. View

12.

Brown Jr R, Broderick J . Unruptured intracranial aneurysms: epidemiology, natural history, management options, and familial screening. Lancet Neurol. 2014; 13(4):393-404. DOI: 10.1016/S1474-4422(14)70015-8. View

13.

Ploch C, Mansi C, Jayamohan J, Kuhl E . Using 3D Printing to Create Personalized Brain Models for Neurosurgical Training and Preoperative Planning. World Neurosurg. 2016; 90:668-674. DOI: 10.1016/j.wneu.2016.02.081. View

14.

Dho Y, Lee D, Ha T, Ji S, Kim K, Kang H . Clinical application of patient-specific 3D printing brain tumor model production system for neurosurgery. Sci Rep. 2021; 11(1):7005. PMC: 7998007. DOI: 10.1038/s41598-021-86546-y. View

15.

Mashiko T, Otani K, Kawano R, Konno T, Kaneko N, Ito Y . Development of three-dimensional hollow elastic model for cerebral aneurysm clipping simulation enabling rapid and low cost prototyping. World Neurosurg. 2013; 83(3):351-61. DOI: 10.1016/j.wneu.2013.10.032. View

16.

Damon A, Clifton W, Valero-Moreno F, Quinones-Hinojosa A . Cost-Effective Method for 3-Dimensional Printing Dynamic Multiobject and Patient-Specific Brain Tumor Models: Technical Note. World Neurosurg. 2020; 140:173-179. DOI: 10.1016/j.wneu.2020.04.184. View

17.

Wang L, Ye X, Hao Q, Ma L, Chen X, Wang H . Three-dimensional intracranial middle cerebral artery aneurysm models for aneurysm surgery and training. J Clin Neurosci. 2018; 50:77-82. DOI: 10.1016/j.jocn.2018.01.074. View

18.

Chawla S, Devi S, Calvachi P, Gormley W, Rueda-Esteban R . Evaluation of simulation models in neurosurgical training according to face, content, and construct validity: a systematic review. Acta Neurochir (Wien). 2022; 164(4):947-966. PMC: 8815386. DOI: 10.1007/s00701-021-05003-x. View

19.

Janes D, Boone D, Dubrowski A . "It's Only Brain Surgery": Using 3D Printing and Simulation to Prepare Rural Physicians for the Management of Acute Epidural Hematoma. Cureus. 2020; 12(10):e11236. PMC: 7704185. DOI: 10.7759/cureus.11236. View

20.

Kosterhon M, Neufurth M, Neulen A, Schafer L, Conrad J, Kantelhardt S . Multicolor 3D Printing of Complex Intracranial Tumors in Neurosurgery. J Vis Exp. 2020; (155). DOI: 10.3791/60471. View