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01-09-2016 | Clinical Article - Vascular

Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms

Authors: Lukas Andereggen, Jan Gralla, Robert H. Andres, Stefan Weber, Gerhard Schroth, Jürgen Beck, Hans Rudolf Widmer, Michael Reinert, Andreas Raabe, Matthias Peterhans

Published in: Acta Neurochirurgica | Issue 9/2016

Abstract

Background

Treatment of complex intracranial aneurysms requires strategic pre-interventional or preoperative planning. In addition to modern three-dimensional (3D) rotational angiography, computed tomography angiography (CTA) or magnetic resonance angiogram (MRA), a solid, tangible 3D model may improve anatomical comprehension and treatment planning. A 3D rapid prototyping (RP) technique based on multimodal imaging data was evaluated for use in planning of treatment for complex aneurysmal configurations.

Methods

Six patients with complex aneurysms were selected for 3D RP based on CTA and 3D rotational angiography data. Images were segmented using image-processing software to create virtual 3D models. Three-dimensional rapid prototyping techniques transformed the imaging data into physical 3D models, which were used and evaluated for interdisciplinary treatment planning.

Results

In all cases, the model provided a comprehensive 3D representation of relevant anatomical structures and improved understanding of related vessels. Based on the 3D model, primary bypass surgery with subsequent reconstruction of the aneurysm was then considered advantageous in all but one patient after simulation of multiple approaches.

Conclusions

Preoperative prediction of intraoperative anatomy using the 3D model was considered helpful for treatment planning. The use of 3D rapid prototyping may enhance understanding of complex configurations in selected large or giant aneurysms, especially those pretreated with clips or coils.

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Title: Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms
Authors: Lukas Andereggen
Jan Gralla
Robert H. Andres
Stefan Weber
Gerhard Schroth
Jürgen Beck
Hans Rudolf Widmer
Michael Reinert
Andreas Raabe
Matthias Peterhans
Publication date: 01-09-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 9/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2892-3

At a glance: The STEP trials

Springer Medicine

Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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