J Cerebrovasc Endovasc Neurosurg.  2023 Mar;25(1):19-27. 10.7461/jcen.2022.E2022.09.002.

Efficacy of 3D-printed simulation models of unruptured intracranial aneurysms in patient education and surgical simulation

• Woo SB
• Lee CY
• Kim CH
• Kwon MY
• Ko YS
• Lee JH
• Heo JC
• Kwon SM

• KMID: 2540804
• DOI: http://doi.org/10.7461/jcen.2022.E2022.09.002

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.

Keyword

Intracranial aneurysm; Patient education; Three-dimensional printing; Simulation

Figure

• 

  Fig. 1. (A) 3D reconstructed image using preoperative DSA of a patient with multiple aneurysms at the superior hypophyseal branch and bifurcation of the left internal carotid artery. (B) The preoperative images were converted into standard triangulated language files. (C) The patient’s 3DPM before manual work. (D) Final 3DPM after manual work to remove the columns attached to the model. DSA, digital subtraction angiography; 3DPM, 3D-printed aneurysm simulation model

• 

  Fig. 2. The 3DPM of a patient with a right MCA bifurcation aneurysm (A), showing a strong correlation with intraoperative microscopic findings (B). Adhesion to the inferior trunk of the M2 segment (black arrow) and the anterior temporal branch of the MCA (white arrow). 3DPM, 3D-printed aneurysm simulation model; MCA, middle cerebral artery

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