Simulation of Endovascular Aortic Repair Using 3D Printed Abdominal Aortic Aneurysm Model and Fluid Pump

Jussi M. Kärkkäinen, Giuliano Sandri, Emanuel R. Tenorio, Amy Alexander, Karen Bjellum, Jane Matsumoto, Jonathan Morris, Bernardo C. Mendes, Randall R De Martino, Gustavo Oderich

Research output: Contribution to journalArticle

Abstract

Background: Abdominal aortic aneurysm (AAA) models can be manufactured with 3D printing technology. This study describes detailed methodology and validation of endovascular aortic repair (EVAR) simulation using 3D printed AAA model connected to hemodynamic pump. Method: The AAA model was printed with Objet500 Connex3 (Stratasys, Eden Prairie, MN) and connected to BDC PD-0500 fluid pump (BDC Laboratories, Wheat Ridge, CO). EVAR procedure metrics were benchmarked in two expert implanters and compared to 20 vascular surgical trainees with different levels of EVAR experience (< 20 or ≥ 20 cases). All simulations were performed using commercially available stent grafts, guidewires, catheters, fluoroscopic guidance and digital subtraction angiography. Studied outcomes included ability to complete the procedure independently, time to deploy aortic component, ability to cannulate contralateral gate and complete the repair, and total fluoroscopy and procedure times. Results: A total of 22 EVAR simulation procedures were performed with mean procedure time of 37 ± 12 min. Experienced trainees had significantly lower total procedural time (32 ± 9 vs. 44 ± 6 min, P = 0.003) and fluoroscopic time (13 ± 5 vs. 23 ± 8 min, P = 0.005). All experienced trainees completed the procedure independently in < 45 min, compared to six (46%) of those with less EVAR experience (P = 0.016). Among less experienced trainees, only two (15%) completed the entire procedure independently (P < 0.001). Benchmark implanters performed significantly better than both trainee groups in nearly all EVAR metrics. Conclusion: EVAR simulation was feasible and simulated all procedural steps with high fidelity. This model may be applicable for assessment of technical competencies and standard endovascular skill acquisition within vascular surgery training curricula.

Original languageEnglish (US)
JournalCardioVascular and Interventional Radiology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Abdominal Aortic Aneurysm
Blood Vessels
Benchmarking
Digital Subtraction Angiography
Fluoroscopy
Carbon Monoxide
Curriculum
Triticum
Stents
Catheters
Hemodynamics
Technology
Transplants

Keywords

  • 3D printing
  • Abdominal aortic aneurysm
  • Endovascular aortic repair
  • EVAR
  • Simulation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Simulation of Endovascular Aortic Repair Using 3D Printed Abdominal Aortic Aneurysm Model and Fluid Pump. / Kärkkäinen, Jussi M.; Sandri, Giuliano; Tenorio, Emanuel R.; Alexander, Amy; Bjellum, Karen; Matsumoto, Jane; Morris, Jonathan; Mendes, Bernardo C.; De Martino, Randall R; Oderich, Gustavo.

In: CardioVascular and Interventional Radiology, 01.01.2019.

Research output: Contribution to journalArticle

Kärkkäinen, Jussi M. ; Sandri, Giuliano ; Tenorio, Emanuel R. ; Alexander, Amy ; Bjellum, Karen ; Matsumoto, Jane ; Morris, Jonathan ; Mendes, Bernardo C. ; De Martino, Randall R ; Oderich, Gustavo. / Simulation of Endovascular Aortic Repair Using 3D Printed Abdominal Aortic Aneurysm Model and Fluid Pump. In: CardioVascular and Interventional Radiology. 2019.
@article{507528b3bdbd4584815c771abda173c4,
title = "Simulation of Endovascular Aortic Repair Using 3D Printed Abdominal Aortic Aneurysm Model and Fluid Pump",
abstract = "Background: Abdominal aortic aneurysm (AAA) models can be manufactured with 3D printing technology. This study describes detailed methodology and validation of endovascular aortic repair (EVAR) simulation using 3D printed AAA model connected to hemodynamic pump. Method: The AAA model was printed with Objet500 Connex3 (Stratasys, Eden Prairie, MN) and connected to BDC PD-0500 fluid pump (BDC Laboratories, Wheat Ridge, CO). EVAR procedure metrics were benchmarked in two expert implanters and compared to 20 vascular surgical trainees with different levels of EVAR experience (< 20 or ≥ 20 cases). All simulations were performed using commercially available stent grafts, guidewires, catheters, fluoroscopic guidance and digital subtraction angiography. Studied outcomes included ability to complete the procedure independently, time to deploy aortic component, ability to cannulate contralateral gate and complete the repair, and total fluoroscopy and procedure times. Results: A total of 22 EVAR simulation procedures were performed with mean procedure time of 37 ± 12 min. Experienced trainees had significantly lower total procedural time (32 ± 9 vs. 44 ± 6 min, P = 0.003) and fluoroscopic time (13 ± 5 vs. 23 ± 8 min, P = 0.005). All experienced trainees completed the procedure independently in < 45 min, compared to six (46{\%}) of those with less EVAR experience (P = 0.016). Among less experienced trainees, only two (15{\%}) completed the entire procedure independently (P < 0.001). Benchmark implanters performed significantly better than both trainee groups in nearly all EVAR metrics. Conclusion: EVAR simulation was feasible and simulated all procedural steps with high fidelity. This model may be applicable for assessment of technical competencies and standard endovascular skill acquisition within vascular surgery training curricula.",
keywords = "3D printing, Abdominal aortic aneurysm, Endovascular aortic repair, EVAR, Simulation",
author = "K{\"a}rkk{\"a}inen, {Jussi M.} and Giuliano Sandri and Tenorio, {Emanuel R.} and Amy Alexander and Karen Bjellum and Jane Matsumoto and Jonathan Morris and Mendes, {Bernardo C.} and {De Martino}, {Randall R} and Gustavo Oderich",
year = "2019",
month = "1",
day = "1",
doi = "10.1007/s00270-019-02257-y",
language = "English (US)",
journal = "CardioVascular and Interventional Radiology",
issn = "7415-5101",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Simulation of Endovascular Aortic Repair Using 3D Printed Abdominal Aortic Aneurysm Model and Fluid Pump

AU - Kärkkäinen, Jussi M.

AU - Sandri, Giuliano

AU - Tenorio, Emanuel R.

AU - Alexander, Amy

AU - Bjellum, Karen

AU - Matsumoto, Jane

AU - Morris, Jonathan

AU - Mendes, Bernardo C.

AU - De Martino, Randall R

AU - Oderich, Gustavo

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Abdominal aortic aneurysm (AAA) models can be manufactured with 3D printing technology. This study describes detailed methodology and validation of endovascular aortic repair (EVAR) simulation using 3D printed AAA model connected to hemodynamic pump. Method: The AAA model was printed with Objet500 Connex3 (Stratasys, Eden Prairie, MN) and connected to BDC PD-0500 fluid pump (BDC Laboratories, Wheat Ridge, CO). EVAR procedure metrics were benchmarked in two expert implanters and compared to 20 vascular surgical trainees with different levels of EVAR experience (< 20 or ≥ 20 cases). All simulations were performed using commercially available stent grafts, guidewires, catheters, fluoroscopic guidance and digital subtraction angiography. Studied outcomes included ability to complete the procedure independently, time to deploy aortic component, ability to cannulate contralateral gate and complete the repair, and total fluoroscopy and procedure times. Results: A total of 22 EVAR simulation procedures were performed with mean procedure time of 37 ± 12 min. Experienced trainees had significantly lower total procedural time (32 ± 9 vs. 44 ± 6 min, P = 0.003) and fluoroscopic time (13 ± 5 vs. 23 ± 8 min, P = 0.005). All experienced trainees completed the procedure independently in < 45 min, compared to six (46%) of those with less EVAR experience (P = 0.016). Among less experienced trainees, only two (15%) completed the entire procedure independently (P < 0.001). Benchmark implanters performed significantly better than both trainee groups in nearly all EVAR metrics. Conclusion: EVAR simulation was feasible and simulated all procedural steps with high fidelity. This model may be applicable for assessment of technical competencies and standard endovascular skill acquisition within vascular surgery training curricula.

AB - Background: Abdominal aortic aneurysm (AAA) models can be manufactured with 3D printing technology. This study describes detailed methodology and validation of endovascular aortic repair (EVAR) simulation using 3D printed AAA model connected to hemodynamic pump. Method: The AAA model was printed with Objet500 Connex3 (Stratasys, Eden Prairie, MN) and connected to BDC PD-0500 fluid pump (BDC Laboratories, Wheat Ridge, CO). EVAR procedure metrics were benchmarked in two expert implanters and compared to 20 vascular surgical trainees with different levels of EVAR experience (< 20 or ≥ 20 cases). All simulations were performed using commercially available stent grafts, guidewires, catheters, fluoroscopic guidance and digital subtraction angiography. Studied outcomes included ability to complete the procedure independently, time to deploy aortic component, ability to cannulate contralateral gate and complete the repair, and total fluoroscopy and procedure times. Results: A total of 22 EVAR simulation procedures were performed with mean procedure time of 37 ± 12 min. Experienced trainees had significantly lower total procedural time (32 ± 9 vs. 44 ± 6 min, P = 0.003) and fluoroscopic time (13 ± 5 vs. 23 ± 8 min, P = 0.005). All experienced trainees completed the procedure independently in < 45 min, compared to six (46%) of those with less EVAR experience (P = 0.016). Among less experienced trainees, only two (15%) completed the entire procedure independently (P < 0.001). Benchmark implanters performed significantly better than both trainee groups in nearly all EVAR metrics. Conclusion: EVAR simulation was feasible and simulated all procedural steps with high fidelity. This model may be applicable for assessment of technical competencies and standard endovascular skill acquisition within vascular surgery training curricula.

KW - 3D printing

KW - Abdominal aortic aneurysm

KW - Endovascular aortic repair

KW - EVAR

KW - Simulation

UR - http://www.scopus.com/inward/record.url?scp=85067646514&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85067646514&partnerID=8YFLogxK

U2 - 10.1007/s00270-019-02257-y

DO - 10.1007/s00270-019-02257-y

M3 - Article

C2 - 31197454

AN - SCOPUS:85067646514

JO - CardioVascular and Interventional Radiology

JF - CardioVascular and Interventional Radiology

SN - 7415-5101

ER -