ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Evaluation of 3D printing in planning, practicing, and training for endovascular lower extremity arterial interventions
Hakan Göçer1, Ahmet Barış Durukan2, Osman Tunç3, Erdinç Naser4, Hasan Alper Gürbüz5, Ercan Ertuğrul6
1Department of Cardiology, Medical Park Uşak Hospital, Uşak, Turkey
2Department of Cardiovascular Surgery, Medical Park Uşak Hospital, Uşak, Turkey
3BTECH Company, METU Technocity, Ankara, Turkey
4Department of Cardiovascular Surgery, Afyon Park Hospital, Afyon, Turkey
5Department of Cardiovascular Surgery, Memorial Ankara Hospital, Ankara, Turkey
6Department of Cardiology, Medical Park İzmir Hospital, Izmir, Turkey
DOI : 10.5606/tgkdc.dergisi.2021.20478
Background: In this study, we aimed to investigate the potential role of 3D-printed physical and digital anatomical models in pre-procedural planning, practice and training in lower extremity arterial interventions.

Methods: A total of 16 patients (9 males, 7 females; mean age: 72.1±1.5 years; range, 69 to 75 years) who underwent superficial femoral artery balloon angioplasty between February 2016 and April 2019 were retrospectively reviewed for vascular access site preference and balloon sizing. Pre-procedural computed tomography volumetric images used for diagnosis were analyzed and modeled with 3D printing. Procedural and 3D-based data regarding the size of the balloon and deployment sites and the severity of the stenosis were compared.

Results: Measurements obtained from 3D models manually and segmentation images from software were similar (p>0.05). Both were smaller than the actual size of balloons used (p<0.001). Stenosis severity was similar with manual and software methods and both were significantly lower than the reported quantitative angiographic measurements (p<0.001). Vascular access site preference was changed in five (31.2%) patients, when the model was simulated by a non-sterile practice on 3D-printed physical models. The wire and catheter selection differed in eight patients, while practicing with models.

Conclusion: The planning and practicing of lower extremity arterial procedures with 3D models may reduce operator-dependent variables, avoid unnecessary interventions, reduce endothelial damage, and increase procedural success. The 3D-printed models may be used for educational purposes for medical professionals.

Keywords : Angioplasty, balloon, MIMICS software, peripheral arterial disease, printing, three-dimensional
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