Tailor-made shaping of microcatheters using three-dimensional printed vessel models for endovascular coil...

Stabilization of microcatheters during coiling after their optimal shaping are key factors for successful endovascular coil embolization of cerebral aneurysms. However, stabilization and optimal shaping of microcatheters are sometimes difficult. Our aim was to introduce "tailor-made" microcatheter shapes for coil embolization using three-dimensional (3D) printed vessel models.

Since August 2014, we have been investigating the use of 3D printed models of intracranial arterial aneurysms to produce optimally shaped microcatheters for endovascular coil embolization. Using Digital Imaging and Communication in Medicine data obtained from preoperative cerebral angiography, a vessel model was produced with a 3D printer using acrylic resin. Preoperative planning of microcatheter navigation and shaping were performed using the 3D vessel models. Before the procedure, microcatheter mandrels were bent manually to the intended angle, referring to the vessel model, and then sterilized. The 3D vessel models were also sterilized with plasma and used during the procedure.

Twenty-six patients (27 aneurysms) were treated using a total of 48 microcatheters shaped while referring to the 3D printed vessel model. Of the 48 catheters, only 9 (19%) required modification of the initial shape due to inappropriate positioning of the catheter. Only 29% of the catheter placements required repositioning due to catheter kick back. There were no procedure-related complications, including aneurysm rupture. The responses from assistants to a questionnaire administered after the embolizations on the usefulness of the technique were favorable.

Tailor-made shaping of microcatheters may facilitate easier and safer procedures in coil embolization of intracranial aneurysm.