title: Stereolithographic models in the interdisciplinary planning of treatment for complex intracranial aneurysms.
abstract: Treatment of complex intracranial aneurysms requires strategic pre-interventional or preoperative planning. In addition to modern three-dimensional (3D) rotational angiography, computed tomography angiography (CTA) or magnetic resonance angiogram (MRA), a solid, tangible 3D model may improve anatomical comprehension and treatment planning. A 3D rapid prototyping (RP) technique based on multimodal imaging data was evaluated for use in planning of treatment for complex aneurysmal configurations.
  
  
  
  Six patients with complex aneurysms were selected for 3D RP based on CTA and 3D rotational angiography data. Images were segmented using image-processing software to create virtual 3D models. Three-dimensional rapid prototyping techniques transformed the imaging data into physical 3D models, which were used and evaluated for interdisciplinary treatment planning.
  
  
  
  In all cases, the model provided a comprehensive 3D representation of relevant anatomical structures and improved understanding of related vessels. Based on the 3D model, primary bypass surgery with subsequent reconstruction of the aneurysm was then considered advantageous in all but one patient after simulation of multiple approaches.
  
  
  
  Preoperative prediction of intraoperative anatomy using the 3D model was considered helpful for treatment planning. The use of 3D rapid prototyping may enhance understanding of complex configurations in selected large or giant aneurysms, especially those pretreated with clips or coils.
authors.affiliation: Department of Neurosurgery, University of Bern, Inselspital, Bern, Switzerland.|Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.|Department of Neurosurgery and F.M. Kirby Neurobiology Centre, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Lukas
authors.initials: L
authors.lastname: Andereggen
authors.affiliation: Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.affiliation: Department of Neurosurgery, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Andres
authors.affiliation: ARTORG Centre for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Weber
authors.affiliation: Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schroth
authors.affiliation: Department of Neurosurgery, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Beck
authors.affiliation: Department of Neurosurgery, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Hans Rudolf
authors.initials: HR
authors.lastname: Widmer
authors.affiliation: Department of Neurosurgery, Neurocenter of Southern Switzerland, 6930, Lugano, Switzerland. Michael.Reinert@eoc.ch.
authors.forename: Michael
authors.initials: M
authors.lastname: Reinert
authors.affiliation: Department of Neurosurgery, University of Bern, Inselspital, Bern, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Raabe
authors.affiliation: ARTORG Centre for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Peterhans
mesh_terms: D000328:Adult; D002533:Cerebral Angiography / Q000379:methods*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D066230:Patient-Specific Modeling
keywords: Coil embolization; Combined therapy; Complex aneurysm; Microsurgical clipping; Rapid prototyping; Revascularization bypass