Abstract
Some reports have addressed the use of three-dimensional (3-D) models in simulated clipping of cerebral aneurysms. To report on the effectiveness of these models, for this study, we developed two types of 3-D models for use in clipping simulations and for clarifying angioarchitecture and surgical approaches.
The two types of model, one made of acrylic polymer and the other made of hollow silicone, were fabricated with a 3-D printer using data obtained with 3-D digital subtraction angiography (3D-DSA). The hollow silicone model was used for simulated clipping, whereas the acrylic model was used as a tool for clarifying angioarchitecture and surgical approaches. We performed simulated clipping of cerebral aneurysms with the two types of 3-D model for 10 patients with 11 cerebral aneurysms.
In 6 of the 11 aneurysms, the first clips accorded with the clipping simulations. The remaining 4 aneurysms exhibited only slight variation from the simulations. In 1 of the 11 aneurysms, the lengths and shapes of the first clips did not accord with the clipping simulations. The hollow silicone model was effective at aiding in the proper selection and manipulation of the clips. The acrylic model was effective at confirming the surgical approach, aneurysm depth, and backside angioarchitecture. Moreover, the procedures were performed smoothly with a microscope without the need to use the monitor, as it was utilized in a clean field.
These two types of 3-D model helped the surgeons gain a clear and intuitive understanding of aneurysm and angioarchitecture in three dimensions. As a result, they were highly useful for simulating clip application.
