Brain Arteriovenous Malformation In Vitro Model for Transvenous Embolization Using 3D Printing and Real Patient Data

Area of Science:

• Neurosurgery
• Medical Imaging
• Biomedical Engineering

Background:

• Transvenous embolization is a novel technique for treating brain arteriovenous malformations (AVMs).
• Successful treatment requires specialized anatomical and technical skills.
• Effective training and testing are crucial for clinician proficiency and patient safety.

Purpose of the Study:

• To develop and validate a patient-specific, 3D-printed in vitro model for transvenous embolization of brain AVMs.
• To assess the impact of hemodynamic factors on embolization outcomes.
• To evaluate the efficacy of adjunctive coiling during embolization.

Main Methods:

• A patient-specific brain AVM in vitro model was created using stereolithography 3D printing.
• A closed pulsed circuit simulated arterial and venous flow dynamics.
• Transvenous embolization was performed using a liquid embolic agent in 12 models, with and without venous coils.

Main Results:

• Lower mean arterial pressure correlated with enhanced retrograde contrast advancement into the nidus.
• The embolization technique effectively replicated clinical practice.
• No significant difference in nidus occlusion rate or injection time was observed between models with and without venous coils (57.6% vs. 61.2%).

Conclusions:

• A functional 3D-printed in vitro brain AVM model was successfully developed for transvenous embolization simulation.
• Hemodynamic parameters, specifically lower mean arterial pressure, influence contrast penetration.
• The addition of venous coils did not demonstrate an embolization advantage in this model.