Article
The use of stereolithographic models in the treatment planning for complex intracranial aneurysms
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Published: | September 16, 2010 |
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Objective: We describe the use of stereolithographic models for surgical planning and intraoperative orientation in patients with complex intracranial aneurysm and discuss the role of this method for improving visualization and decision making.
Methods: Stereolithographic models of consecutive five patients were derived from CT, CT-angiography (CT-A) and three-dimensional rotational cerebral angiography (3D-RA) data and were fused together. Based on the information gained from different imaging studies such as CT and CTA on one hand and 3D-RA on the other hand, several different modalities could be analyzed simultaneously such as the shape and extends of the aneurysm, thrombosis, vascular implants of a previous surgery or endovascular intervention as well as the courses of target and donor vessels were defined. The 3D-stereolithographic model integrated these structures within a 3D object.
Results: In five patients with complex aneurysms (4 MCA, 1 PCA), the 3D- remodeling could be adequately achieved using CTA and 3D-RA. In all cases the model fulfilled the requirement of the neurovascular team for optimal 3D assessment of the relevant structures down to an object size of 1 mm and helped to better understand the complex anatomical configuration.
Conclusions: Treatment of giant aneuryms either by endovascular or microsurgical or combined approach remain a complex task. Our series of 3D stereolithographic models demonstrates the feasibility and clinical utility of a new visualization medium for cerebrovascular neurosurgery in giant partially thrombosed aneurysm foreseen for an EC-IC bypass.