Comparison of Two Three-Dimensional Printed Models of Complex Intracranial Aneurysms for Surgical Simulation

Abstract

Objective: To compare two 3-dimensional (3D) printed models of intracranial aneurysms for simulation and training for complex aneurysm surgery.

Methods: The study included 6 complex or large aneurysm cases. We printed two 3D models of complex aneurysms based on computed tomography angiography data using a 3D printer: a whole model, which was all-in-one printed hollow aneurysm method with colorful and multiple materials and included the hollow aneurysm, adjacent arteries, skull base, and nerves, and a regional model that included the hollow aneurysm and adjacent arteries. The 3D models were used for surgical planning and for practice in craniotomy and clipping. Neurosurgeons rated the models via questionnaires.

Results: Both 3D aneurysm models were accurate: the diameter, width, and neck of the aneurysms in the models were not significantly different from the computed tomography angiography data (P > 0.05). Furthermore, the models were useful for selecting clips before surgery. The whole 3D model improved understanding of the surgical view more than the regional model did (P < 0.05); however, the clip application felt more realistic in the regional model (P < 0.05). The process time for making the whole model is shorter (P < 0.05) but more expensive (P < 0.05) compared with the regional model.

Conclusions: The whole and regional 3D printed aneurysm models were accurate. The whole model was more useful for planning the trajectory of approach to the aneurysm when it was located in close proximity to bone and nerves, whereas the regional 3D aneurysm model was appropriate for aneurysms not involving bone and nerves. This will help neurosurgeon choose the proper 3D model for the complex aneurysm surgery according to the comparison.

Keywords: Aneurysm; Clipping; Surgery simulator; Surgical training; Three-dimensional model; Three-dimensional printing.