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Made of polylactic acid 3D building virtual model of a normal (a) and coiling (b) internal carotid arteries fabricated using MakerBot 3D printer
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The purpose of this study is to recreate live patient arterial anomalies using new recent application of three-dimensional (3D) printed anatomical models. Another purpose of building such models is to evaluate the effectiveness of angiographic data. With the help of the DICOM files from computed tomographic angiography (CT-A), we were able to build...
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Citations
... This study avoided the problems related to the usage of cadavers in medical educational by utilizing 3D models. A review of the literature revealed that in addition to the studies focusing on a single case model, the number of studies involving model measurements is also limited [11,12]. ...
... The study also showed that they were beneficial as they guided anatomy learning with accuracy and enabled the observers the ability to differentiate between the structures, and the pliability of structures (Tables 1 and 2). As previous studies have demonstrated, 3D cardiovascular models could be an effective tool in anatomy teaching and learning, evaluating it from diverse perspectives such as accuracy, ease of use, teaching efficiency, and individual preferences [11,12,22,23]. Compared with cadaveric material, beginner stage students do prefer to work with 3D prints [5,9,18,25]. ...
Purpose
This article aims to discuss the use of three-dimensional (3D) printed models of vascular variation cases as an educational tool for undergraduate and postgraduate anatomy students.
Methods
This advanced study involved ten anatomy assistants who were provided with five distinct cases of congenital cardiovascular variations, each accompanied by a computed tomography angiography (CT-A) and 1:1 solid model format. The residents were asked to generate perceptions for both formats and then compare these perceptions based on identifying the variation, defining the structural features, and evaluating relevant educational perspectives.
Results
The vascular origin measurement values compared to the statistically evaluated real values of the related cases showed that models were 1:1 identical copies. Qualitative assessment feedback from five stations supported the usefulness of 3D models as educational tools for organ anatomy, simulation of variational structures, and overall medical education and anatomy training. Models showcasing different anatomical variations such as aortic arch with Type 2 pattern, a right-sided aortic arch with Type 2 pattern, an aberrant right subclavian artery, arteria lusoria in thorax, and a left coronary artery originating from pulmonary trunk in an Alcapa type pattern allow for better analysis due to their complex anatomies, thus optimizing the study of variation-specific anatomy. The perception level in the 3D model contained higher points in all of the nine parameters, namely identification of cardiovascular variations, defining the vessel with anomaly, aortic arch branch count and appearance order, feasibility of using it in peers and student education. 3D models received a score 9.1 points, while CT-A images were rated at 4.8 out of 10.
Conclusion
3D printed anatomical models of variational cardiovascular anatomy serve as essential components of anatomy training and postgraduate clinical perception by granting demonstrative feedback and a superior comprehension of the visuospatial relationship between the anatomical structures.
... Additionally, since 3Dp models are non-biohazardous, they do not need specialised labs or equipment and are relatively easy to dispose of, they do not present the same logistical issues as cadaveric specimens [13]. 3Dp models exhibit spatial relationships more clearly than digital representations do, making them valuable in training and education [11]. ...
... This process uses thermoplastic filaments extruded into hot dies where they melt [5]. Several ongoing researches are being conducted to extend the medical applications of 3D printing methods in the various fields, such as tissue engineering [6], surgical training equipment [7], and bone repairing [8] as well as the development of permanent non-biologic implants, bioactive scaffolds, and pathological organs [9]. ...
In this paper, high cycle fatigue behavior and thermal properties of blend specimens made of polylactic acid (PLA) and polycaprolactone (PCL) were studied and the influence of crystallization was investigated on the fatigue behavior. In this regard, fused deposition modeling method was employed to manufacture neat-PLA, neat-PCL, PLA/10wt.% PCL (90/10), and PLA/20wt.% PCL (80/20) specimens. The results show that the addition of 10wt.% and 20wt.% of PCL to the neat-PLA increases the elongation of the specimens by 32% and 284%, respectively, compared to that of the neat-PLA. However, Young’s modulus respectively decreases by 22% and 34%. According to the differential scanning calorimetry (DSC) test results, the 90/10 blend has the highest Xc, PLA (10.5%) in comparison to the neat-PLA and 80/20 blend. The implementation of high cycle fatigue (HCF) tests on the 3D printed specimens indicated that the 90/10 blend offer the best HCF behavior. In addition, the neat-PLA, 90/10, and 80/20 exhibit a fatigue limit of 9.39 MPa, 15.47 MPa, and 13.62 MPa, respectively. These results reveal the direct effect of crystallinity (Xc, PLA) on the fatigue behavior of the specimens. The fractography evaluation exhibited that adding PCL to PLA may cause the formation of numerous voids in the 80/20 blend, resulting in degradation in fatigue strength especially under higher stress amplitudes.
... The most common phantoms are 3D-printed skulls in different plastic materials [4][5][6][7]. Phantoms have also been created for the modelling of vascular structures, including cerebral artery aneurysms [8] and complex anatomical variations of the internal carotid artery [9]. In ear, nose, and throat (ENT) surgery, 3D-printed phantoms have been used for testing AR systems in middle ear surgery [10] and for simulation of sinus and nasal cavity surgery, where the nasal cavities were included in the phantoms [11]. ...
Background:
Neurosurgical procedures are complex and require years of training and experience. Traditional training on human cadavers is expensive, requires facilities and planning, and raises ethical concerns. Therefore, the use of anthropomorphic phantoms could be an excellent substitute. The aim of the study was to design and develop a patient-specific 3D-skull and brain model with realistic CT-attenuation suitable for conventional and augmented reality (AR)-navigated neurosurgical simulations.
Methods:
The radiodensity of materials considered for the skull and brain phantoms were investigated using cone beam CT (CBCT) and compared to the radiodensities of the human skull and brain. The mechanical properties of the materials considered were tested in the laboratory and subsequently evaluated by clinically active neurosurgeons. Optimization of the phantom for the intended purposes was performed in a feedback cycle of tests and improvements.
Results:
The skull, including a complete representation of the nasal cavity and skull base, was 3D printed using polylactic acid with calcium carbonate. The brain was cast using a mixture of water and coolant, with 4 wt% polyvinyl alcohol and 0.1 wt% barium sulfate, in a mold obtained from segmentation of CBCT and T1 weighted MR images from a cadaver. The experiments revealed that the radiodensities of the skull and brain phantoms were 547 and 38 Hounsfield units (HU), as compared to real skull bone and brain tissues with values of around 1300 and 30 HU, respectively. As for the mechanical properties testing, the brain phantom exhibited a similar elasticity to real brain tissue. The phantom was subsequently evaluated by neurosurgeons in simulations of endonasal skull-base surgery, brain biopsies, and external ventricular drain (EVD) placement and found to fulfill the requirements of a surgical phantom.
Conclusions:
A realistic and CT-compatible anthropomorphic head phantom was designed and successfully used for simulated augmented reality-led neurosurgical procedures. The anatomic details of the skull base and brain were realistically reproduced. This phantom can easily be manufactured and used for surgical training at a low cost.
... With the advent of CAD/CAM surgeons can now view 3D visual representation of the vascular ring situated anywhere in the brain (Chong et al., 1999;Govsa et al., 2017;Banga et al., 2017). Various image processing software programs are used for pre-surgical planning of reconstruction and rehabilitation of anatomical defects. ...
... With the advent of CAD/CAM surgeons can now view 3D visual representation of the vascular ring situated anywhere in the brain (Chong et al., 1999;Govsa et al., 2017;Banga et al., 2017). Various image processing software programs are used for pre-surgical planning of reconstruction and rehabilitation of anatomical defects. ...
... Second, an objective and well-established tool with previous applications in other areas was used for volumetric calculation. 47,48 Third, the present study yields a detailed visual representation of critical breast cleavage areas and describes a step-by-step analysis to provide surgeons with a standardization system for identifying adverse zones in hybrid breast augmentation. ...
Background:
Autologous fat grafting (AFG) is a procedure indicated for breast augmentation (BA) to improve coverage of silicone implants and redesign breast shape. Different techniques are based on parameters such as intermammary distance and implant volume/projection, none of which have been systematically standardized according to the main areas for AFG placement. This study presents a method utilizing breast zone standardization based on breast anatomy and implant location to promote natural superior/medial breast poles and achieve an anatomical composite breast.
Material/methods:
The authors performed this zone standardization in 76 breasts (38 patients) undergoing primary/secondary hybrid BA. An upper/medial pole area between the implant and the clavicle region and parasternal area was marked to receive subsequent AFG and divided into three zones. A mathematical formula (VAFG= (π. r2.p)/4.8) was used to estimate the volume of fat grafts according to implant volume in the respective zones.
Results:
Implant volumes ranged from 205 to 375 cc (mean: 265 cc), and patients received an average AFG volume of 105.3 cc per breast (range: 36-135 cc); the average fat graft volume in zones I-II and III was 78.28 (range: 0-100 cc) and 27.03 (15-60 cc), respectively. Three cases of minor complications were observed in 2 patients (5.2%) during a mean follow-up of 12.8 months (6-19 months). A high correlation was observed between the AFG performed in the cohort and predictions obtained from the formula (p<0.001).
Conclusion:
Recognizing risky cleavage breast zones between the implant pocket and upper and medial quadrants remains essential to attain satisfactory outcomes and minimize adverse results. Although experience and proper judgment are still important in the AFG technique, the data presented here offer plastic surgeons an additional standardized framework to help deliver predictable HBA.
... [4][5][6] These models have shown value as training models for use with medical imaging. 7 Current silicone-and glass-based models simulate hemodynamic conditions and aid in developing treatment strategies. Still, significant differences in the model material properties and actual human vascular tissue properties remain a considerable limitation. ...
Vessel models are a first step in developing endovascular medical devices. However, these models, often made from glass or silicone, do not accurately represent the mechanical properties of human vascular tissue, limiting their use to basic training and proof-of-concept testing. This study outlines methods to quantify human vascular tissue mechanical properties and synthetic biomaterials for creating representative vessel models. Human vascular tissue was assessed and compared to silicone and new UV-cured polymers (VC-A30) using the following eight mechanical tests: compressive, shear, tensile dynamic elastic modulus, Poisson's ratio, hardness, radial force, compliance, and lubricity. Half of these testing methods were nondestructive, allowing for multiple mechanical and histological characterizations of the same human tissue sample. Histological evaluation of the cellular and extracellular matrix of the human vessels verified that the dynamic moduli and Poison's ratio tests were nondestructive. Fluid absorption by VC-A30 showed statistically significant softening of mechanical properties, stabilizing after 4 days in phosphate-buffered saline (PBS). Human vasculature exhibited notably similar results to VC-A30 in five of eight mechanical tests (≤30% difference) versus two of eight for standard silicone (≤38% difference). Results show that VC-A30 provides a new option for 3D-printing translucent in vitro vascular models with anatomically relevant mechanical properties. These new vessel analogs may simulate patient-specific vessel disease states, improve surgical training models, accelerate new endovascular device developments, and ultimately reduce the need for animal models.
... We found no significant discrepancies in our study. Although computer-assisted 3D morphology assessments are of much value for aneurysm size and neck measurements compared to 2D images [25], a solid 3D model can provide supplementary information, especially in preoperative planning [26,27]. Wang et al. concluded that the printed models were useful for understanding the aneurysm's structure and for choosing the necessary clips before surgery, mainly for junior neurosurgeons [17], and Hoffman et al. suggested that fabrication of 3D printing and hollow models are helpful in EVAR planning for complex abdominal aorta aneurysms [28]. ...
Many developments were made in the area of endovascular treatment of intracranial aneurysms, but this procedure also requires a good assessment of vascular anatomy prior to intervention. Seventy-six cases with brain aneurysms were selected and 1:1 scale 3D printed models were created. We asked three interventional neurosurgeons with different degrees of experience (ten years, four years, and a fourth-year resident) to review the cases using CTA (computed tomography angiogram) with MPR (multiplanar reconstructions) and VRT (volume rendering technique) and make a decision: coil embolization or stent-assisted coil embolization. After we provided them with the 3D printed models, they were asked to review their treatment plan. Statistical analysis was performed and the endovascular approach changed in 11.84% of cases for ten-year experienced neurosurgeons, 13.15% for four years experienced neurosurgeon, and 21.05% for residents. The interobserver agreement was very good between the ten years experienced interventionist and four years experienced interventionist when they analyzed the data set that included the 3D printed model. The agreement was higher between all physicians after they examined the printed model. 3D patient-specific printed models may be useful in choosing between two different endovascular techniques and also help the residents to better understand the vascular anatomy and the overall procedure.
... [3][4][5][6] Phantoms have also been created for modelling of vascular structures, including cerebral artery aneurysms 7 and complex internal carotid artery variants. 8 In Ear, Nose and Throat (ENT) surgery, 3D-printed phantoms have been used for testing AR systems in middle ear surgery 9 and for simulation of sinus and nasal cavity surgery, where the nasal cavities were included in the phantoms. 10 For simulating brain biopsies, brain phantoms have been designed to mimic brain tissue and lesions, and placed inside a cadaveric human skull. ...
Neurosurgical procedures require high accuracy and skills, so that practical surgical training is a key factor for successful patient outcomes. Neurosurgical training has been traditionally performed on human cadavers, or more recently on simulation models including virtual reality (VR) platforms. However, these methods have several drawbacks, including ethical and practical concerns. Anthropomorphic phantoms could solve most of the issues related to cadaveric models, and are suitable for simulating several neurosurgical procedures. The aim of this study was to design a realistic and CT-compatible anthropomorphic head phantom that could be used for surgical training and simulation, with a speci�c focus on endo-nasal skull-base surgery and brain biopsy. A head phantom was created by segmenting a Cone Beam Computed Tomography (CBCT) image and a T1-weighted MR image from a cadaver. The skull, which includes a complete structure of the nasal cavity and detailed skullbase anatomy, is 3D printed using PLA with calcium. The brain phantom is produced using a 3D printed mold, casting a mixture of PVA, water and coolant. The radiodensity and mechanical properties of the phantom were
tested and adjusted in material choice to mimic real-life conditions. In general, surgeons have a positive attitude in using the phantom. The skull and the eloquent structures at the skull-base, as well as the brain parenchyma were realistically reproduced. The head phantom can be employed for neurosurgical education, training and surgical planning, and can be successfully used for simulating endo-nasal skull-base surgery and brain biopsies.
