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Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices.
J Vasc Surg Cases Innov Tech 2019; 5(4):566-571JV

Abstract

Fenestrated endovascular aneurysm repair is frequently used for juxtarenal and pararenal aortic aneurysms. In urgent cases, however, the use of premanufactured patient-specific devices is not an option. Physician-modified endografts may be used to treat these patients but require experience and a steep learning curve for accurate planning to position fenestrations and to perform the graft modifications. Despite experience, a margin of error in placing fenestrations always exists, and a mismatch possibility between the fenestration and vessel ostium can lead to increased cannulation time and stent complications, including target vessel loss. Aortic three-dimensional printing has been widely described in medicine for simulation, training, and surgical planning. Commercial software is currently under investigation for planning of fenestrated endovascular aneurysm repair at high costs. We describe an effective and inexpensive technique using free computer-aided design software to create a real 1:1 aortic 3D model that can easily be printed and quickly sterilized. This aortic model can be used to create a physician-modified endograft and to place fenestrations in an accurate way, with potential for shorter and more precise procedures and better long-term results. Two cases are presented to illustrate the technique, demonstrating that 3D printing is a valuable tool to plan, design, and create fenestrated devices more accurately.

Authors+Show Affiliations

Department of Vascular and Endovascular Surgery, Hospital Universitario Mayor Mederi and Hospital San Ignacio, Bogotá, Colombia.Department of Vascular Surgery, Hospital Militar Central, Bogotá, Colombia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31891021

Citation

Barón, Vladimir, and Romeo Guevara. "Three-dimensional Printing-guided Fenestrated Endovascular Aortic Aneurysm Repair Using Open Source Software and Physician-modified Devices." Journal of Vascular Surgery Cases and Innovative Techniques, vol. 5, no. 4, 2019, pp. 566-571.
Barón V, Guevara R. Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices. J Vasc Surg Cases Innov Tech. 2019;5(4):566-571.
Barón, V., & Guevara, R. (2019). Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices. Journal of Vascular Surgery Cases and Innovative Techniques, 5(4), pp. 566-571. doi:10.1016/j.jvscit.2019.08.006.
Barón V, Guevara R. Three-dimensional Printing-guided Fenestrated Endovascular Aortic Aneurysm Repair Using Open Source Software and Physician-modified Devices. J Vasc Surg Cases Innov Tech. 2019;5(4):566-571. PubMed PMID: 31891021.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three-dimensional printing-guided fenestrated endovascular aortic aneurysm repair using open source software and physician-modified devices. AU - Barón,Vladimir, AU - Guevara,Romeo, Y1 - 2019/11/22/ PY - 2019/05/03/received PY - 2019/08/20/accepted PY - 2020/1/1/entrez PY - 2020/1/1/pubmed PY - 2020/1/1/medline KW - 3D printing KW - FEVAR KW - Juxtarenal aneurysm KW - Physician-modified endograft SP - 566 EP - 571 JF - Journal of vascular surgery cases and innovative techniques JO - J Vasc Surg Cases Innov Tech VL - 5 IS - 4 N2 - Fenestrated endovascular aneurysm repair is frequently used for juxtarenal and pararenal aortic aneurysms. In urgent cases, however, the use of premanufactured patient-specific devices is not an option. Physician-modified endografts may be used to treat these patients but require experience and a steep learning curve for accurate planning to position fenestrations and to perform the graft modifications. Despite experience, a margin of error in placing fenestrations always exists, and a mismatch possibility between the fenestration and vessel ostium can lead to increased cannulation time and stent complications, including target vessel loss. Aortic three-dimensional printing has been widely described in medicine for simulation, training, and surgical planning. Commercial software is currently under investigation for planning of fenestrated endovascular aneurysm repair at high costs. We describe an effective and inexpensive technique using free computer-aided design software to create a real 1:1 aortic 3D model that can easily be printed and quickly sterilized. This aortic model can be used to create a physician-modified endograft and to place fenestrations in an accurate way, with potential for shorter and more precise procedures and better long-term results. Two cases are presented to illustrate the technique, demonstrating that 3D printing is a valuable tool to plan, design, and create fenestrated devices more accurately. SN - 2468-4287 UR - https://www.unboundmedicine.com/medline/citation/31891021/Three-dimensional_printing-guided_fenestrated_endovascular_aortic_aneurysm_repair_using_open_source_software_and_physician-modified_devices L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-4287(19)30117-0 DB - PRIME DP - Unbound Medicine ER -