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Abstract
Introduction Atherosclerotic disease has been described as an important underlying etiology of refractory occlusions. Despite being challenging thrombectomy procedures for interventionalists, clinically accurate simulation flow models have not yet been developed.
Aim of Study To develop and test a 3D-printed stenosis model for research and training purposes.
Methods Stereolithography 3D-printing was used to create an elastic neurovascular model based on vascular anatomies extracted from anonymized CTA images. The phantom includes the aortic arch, bilateral carotid arteries, and a complete circle of Willis up to the M2-MCA, A2-ACA, and P2-PCA segments. To produce the stenotic segments, 3% sodium alginate solution was cast into stenosis molds featuring different geometries and then crosslinked in a 40% calcium chloride solution.
Results An 80% MCA-M1 stenosis (8mm-long segment with a luminal diameter of 0.5mm) and a 90% ICA stenosis (30mm-long segment with a luminal diameter of 0.7mm) were successfully implemented in the neurovascular flow model. The neurointerventionalist performing the simulation of the procedure deemed the angioplasty as intricate, consistent with the complexity often associated with severe stenosis. Angioplasties performed without a protection device resulted in visible emboli collected in a filter placed in the outflow of the model. Figure 1 and 2 represent intracranial and extracranial stenosis, respectively, with their corresponding postprocessed filter image after angioplasty treatment. Emboli parameters are included in both figures.
Conclusion A workflow for stenosis implementation inside a clinically accurate 3D model has been proposed as the first step toward educating future neurointerventionalists on performing endovascular treatment in severe stenosis.
Disclosure of Interest no.