title: Microcatheter Shaping for Intracranial Aneurysm Coiling Using the 3-Dimensional Printing Rapid Prototyping Technology: Preliminary Result in the First 10 Consecutive Cases.
abstract: OBJECTIVE
  An optimal microcatheter is necessary for successful coiling of an intracranial aneurysm. The optimal shape may be predetermined before the endovascular surgery via the use of a 3-dimensional (3D) printing rapid prototyping technology. We report a preliminary series of intracranial aneurysms treated with a microcatheter shape determined by the patient's anatomy and configuration of the aneurysm, which was fabricated with a 3D printer aneurysm model.
  
  
  METHODS
  A solid aneurysm model was fabricated with a 3D printer based on the data acquired from the 3D rotational angiogram. A hollow aneurysm model with an identical vessel and aneurysm lumen to the actual anatomy was constructed with use of the solid model as a mold. With use of the solid model, a microcatheter shaping mandrel was formed to identically line the 3D curvature of the parent vessel and the long axis of the aneurysm. With use of the mandrel, a test microcatheter was shaped and validated for the accuracy with the hollow model. All the planning processes were undertaken at least 1 day before treatment. The preshaped mandrel was then applied in the endovascular procedure. Ten consecutive intracranial aneurysms were coiled with the pre-planned shape of the microcatheter and evaluated for the clinical and anatomical outcomes and microcatheter accuracy and stability.
  
  
  RESULTS
  All of pre-planned microcatheters matched the vessel and aneurysm anatomy. Seven required no microguidewire assistance in catheterizing the aneurysm whereas 3 required guiding of a microguidewire. All of the microcatheters accurately aligned the long axis of the aneurysm. The pre-planned microcatheter shapes demonstrated stability in all except in 1 large aneurysm case.
  
  
  CONCLUSIONS
  When a 3D printing rapid type prototyping technology is used, a patient-specific and optimal microcatheter shape may be determined preoperatively.
authors.affiliation: Center for Endovascular Therapy, Division of Neuroendovascular Surgery, Jichi Medical University, Tochigi, Japan. Electronic address: knamba@jichi.ac.jp.
authors.forename: Katsunari
authors.initials: K
authors.lastname: Namba
authors.affiliation: Department of Neurosurgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Ayuho
authors.initials: A
authors.lastname: Higaki
authors.affiliation: Department of Neurosurgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kaneko
authors.affiliation: Department of Neurosurgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Mashiko
authors.affiliation: Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Nemoto
authors.affiliation: Department of Neurosurgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Eiju
authors.initials: E
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D002404:Catheterization; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D066330:Printing, Three-Dimensional
keywords: Aneurysm; Coiling; Microcatheter shaping; Rapid prototyping; Three-dimensional printing