J Cerebrovasc Endovasc Neurosurg.  2021 Mar;23(1):16-22. 10.7461/jcen.2021.E2020.08.005.

Optimal microcatheter shaping method customized for a patient-specific vessel using a three-dimensional printer

• Kim TG

• KMID: 2514334
• DOI: http://doi.org/10.7461/jcen.2021.E2020.08.005

Abstract

Objective
In coil embolization of cerebral aneurysms, it is very important to guide microcatheters to the appropriate location in the aneurysm and stabilize them during procedures. To do this, microcatheters need to be properly shaped. In this study, we aim to use a computer application program and a three-dimensional (3D) printer to make a patientspecific shaped microcatheter.
Methods
We simplified, skeletalized, and oversized the existing 3D vascular imaging structures and created the central line structure of the blood vessels. These processes were performed using a computer application program developed by our team. The microcatheters were shaped according to the skeletalized data shape, and the catheterization procedures were simulated using the 3D hollow model of the blood vessel region of interest; the number of hollow models was 10. The compatibility of the microcatheters shaped according to the skeletalized data shape was validated if the microcatheter tip was positioned into the aneurysm.
Results
In all 10 hollow models, the positioning of the microcatheter into the aneurysms was successful following one or two attempts.
Conclusions
When shaping microcatheters during endovascular coil embolization, it may be useful to use central line structures with some expansions customized for a patientspecific vessel using a computer application program and a 3D printer. In the future, it may be necessary to apply this technique to actual patients.

Keyword

‌Intracranial aneurysm, Therapeutic embolization, Software

Figure

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  Fig. 1. Three-dimensional image data obtained using conventional cerebral angiography

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  Fig. 2. The blood vessel regions of interest, extracted from the 3D image data from entire blood vessels.

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  Fig. 3. The central line value of a blood vessel obtained by calculation using the computer application program we developed. BVPF, Blood Vessel Path Finder.

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  Fig. 4. A 3D model of the central line values of the blood vessel region of interest, which is a 3D printer output of the central line value of a blood vessel obtained in Fig. 3.

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  Fig. 5. (A, B) A 3D hollow model of a patient’s blood vessel regions of interest, created using a 3D printer.

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  Fig. 6. The simulation procedure of catheterization into the aneurysm using the 3D hollow model of the blood vessel regions of interest. These procedures could be visually observed because the 3D hollow model was semi-transparent due to the use of clear resins.

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  Fig. 7. Ten 3D hollow model, including (according to the sequence from left to right) two internal cerebral artery-paraclinoid aneurysms, two internal cerebral artery-posterior communicating artery aneurysms, two anterior cerebral artery aneurysms, two middle cerebral artery aneurysms, and two posterior circulation aneurysms.

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