Application of a Three-dimensional Printed Anatomical Model in Presurgical Planning of Surgical Treatment of Brain Aneurysms

Abstract

Three dimensional (3D) printed models represent innovative tools in anatomy teaching and surgical planning. The present study aimed at generating 3D skull models incorporating middle cerebral artery (MCA) aneurysms and in assessing their anatomical accuracy and utility as training and preoperative planning tools. Two aneurysm models were generated. Initially, a full skull (model A) and subsequently a half skull (model B) using white polyactic acid (PLA) filament incorporating two arterial networks with hard black PLA filament (in model A) and a softer semitransparent filament (in model B). The models were based on computed tomographic angiography (CTA) of a female patient suffering from bilateral unruptured middle cerebral aneurysms. Model A, a high contrast model, was designed for anatomical illustration purposes. Model B was designed to allow for clipping simulations. The anatomical accuracy of the two models compared to CTA was assessed by measuring their dimensions at the neck, proximal, distal branches and fundus, using an electronic micrometer. The utility of the models for the comprehension of the underlying anatomy, pathology and preoperative planning was evaluated by means of online questionnaires following clipping simulations conducted by neurosurgery residents and specialized neurosurgeons. Of the two 3D printed models generated, model B (clipping model) showed the highest degree of anatomical accuracy. The results of the online survey on the utility of the proposed models indicate that the majority of participants accepted the innovation with positive responses and approve the use of 3D printed aneurysm models for preoperative planning and resident training.