title: Rapid prototyping compliant arterial phantoms for in-vitro studies and device testing.
abstract: BACKGROUND
  Compliant vascular phantoms are desirable for in-vitro patient-specific experiments and device testing. TangoPlus FullCure 930 is a commercially available rubber-like material that can be used for PolyJet rapid prototyping. This work aims to gather preliminary data on the distensibility of this material, in order to assess the feasibility of its use in the context of experimental cardiovascular modelling.
  
  
  METHODS
  The descending aorta anatomy of a volunteer was modelled in 3D from cardiovascular magnetic resonance (CMR) images and rapid prototyped using TangoPlus. The model was printed with a range of increasing wall thicknesses (0.6, 0.7, 0.8, 1.0 and 1.5 mm), keeping the lumen of the vessel constant. Models were also printed in both vertical and horizontal orientations, thus resulting in a total of ten specimens. Compliance tests were performed by monitoring pressure variations while gradually increasing and decreasing internal volume. Knowledge of distensibility was thus derived and then implemented with CMR data to test two applications. Firstly, a patient-specific compliant model of hypoplastic aorta suitable for connection in a mock circulatory loop for in-vitro tests was manufactured. Secondly, the right ventricular outflow tract (RVOT) of a patient necessitating pulmonary valve replacement was printed in order to physically test device insertion and assess patient's suitability for percutaneous pulmonary valve intervention.
  
  
  RESULTS
  The distensibility of the material was identified in a range from 6.5 × 10(-3) mmHg(-1) for the 0.6 mm case, to 3.0 × 10(-3) mmHg(-1) for the 1.5 mm case. The models printed in the vertical orientation were always more compliant than their horizontal counterpart. Rapid prototyping of a compliant hypoplastic aorta and of a RVOT anatomical model were both feasible. Device insertion in the RVOT model was successful.
  
  
  CONCLUSIONS
  Values of distensibility, compared with literature data, show that TangoPlus is suitable for manufacturing arterial phantoms, with the added benefit of being compatible with PolyJet printing, thus guaranteeing representative anatomical finishing, and quick and inexpensive fabrication. The appealing possibility of printing models of non-uniform wall thickness, resembling more closely certain physiological scenarios, can also be explored. However, this material appears to be too stiff for modelling the more compliant systemic venous system.
authors: Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Great Ormond Street Hospital for Children, NHS Trust, London, UK. g.biglino@ucl.ac.uk
authors: Giovanni
authors: G
authors: Biglino
authors: Peter
authors: P
authors: Verschueren
authors: Raf
authors: R
authors: Zegels
authors: Andrew M
authors: AM
authors: Taylor
authors: Silvia
authors: S
authors: Schievano
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology; D062186:Arterial Pressure; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D003187:Compliance; D017076:Computer-Aided Design; D005240:Feasibility Studies; D006330:Heart Defects, Congenital / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000295:instrumentation*; D008422:Materials Testing; D008953:Models, Anatomic; D019047:Phantoms, Imaging; D011474:Prosthesis Design