Use of patient specific 3D printed (3DP) neurovascular phantoms for mechanical assessment of devices used in image guided minimally invasive procedures

摘要

Purpose: Patient-specific 3D printed phantoms (3DP) can reproduce accurate patient geometry and provide precise tools for Endovascular Image Guided Interventions (EIGI) simulations. We propose to build and test 3DP phantoms which mimic the arterial wall elasticity and surface properties and demonstrate their utility in comprehensive EIGI simulations. Materials and Methods: 3DP idealized and patient specific vascular phantoms were manufactured using Stratasys Objet 500 Connex 3. The idealized phantoms were created using a sine wave shape, patient specific phantoms were based on CT- angiography volumes. The phantoms were coated with a hydrophilic material to mimic vascular surface properties. We tested various endovascular procedures using an Interventional Device Testing Equipment (IDTE) 2000 and measured push/pull force used to actuate endovascular devices during EIGIs.Results: The force needed to advance devices in neurovascular phantoms varied based on tortuosity, material and coating, ranging from -3 to 21 grams-force. Hydrophilic coating reduced maximum force from 21 to 4.8 grams-force in the same model. IDTE 2000 results of neurovascular models were compared to hand manipulation of guidewire access using a six-axis force sensor with forces ranging from -50 to 440 grams. The clot retriever tested in carotid models experienced most friction around tortuous bends ranging from -65 to -90 grams-force, with increasing rigidity of materials creating increased friction. Sine wave model forces varied from -2 to 105 grams.Conclusions: 3DP allows manufacturing of vascular phantoms with precise mechanical and surface properties which can be used for EIGI simulations for imaging protocol optimization and device behavior assessment.