Göçer Hakan, Durukan Ahmet Barış, Tunç Osman, Naseri Erdinç, Ercan Ertuğrul
Department of Cardiology, Medical Park Uşak Hospital, Uşak, Turkey.
Department of Cardiovascular Surgery, Medical Park Uşak Hospital, Uşak, Turkey.
Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Apr 22;28(2):294-300. doi: 10.5606/tgkdc.dergisi.2020.18939. eCollection 2019 Jun.
We aimed to investigate the potential role of threedimensional printed anatomical models in pre-procedural planning, practice, and selection of carotid artery stent and embolic protection device size and location.
A total of 16 patients (10 males, 6 females; mean age 75.6±4.7 years; range, 68 to 81 years) who underwent carotid artery stenting with an embolic protection device between January 2017 and February 2019 were retrospectively analyzed. The sizing was based on intraprocedural angiography findings with the same brand stent using distal protection device. Pre-procedural computed tomography angiography images used for diagnosis were obtained and modeled with three-dimensional printing method. Pre-procedural and threedimensional data regarding the size of stents and protection devices and implantation sites were compared.
Measurements obtained from three-dimensional models manually and segmentation images from software were found to be similar and both were smaller than actually used for stent and embolic protection device sizes. The rates of carotid artery stenosis were similar with manual and software methods, but were lower than the quantitative angiographic measurements. Device implantation sites detected by the manual and software methods were different than the actual setting.
The planning and practicing of procedure with threedimensional models may reduce the operator-dependent variables, shorten the operation time, decrease X-ray exposure, and increase the procedural success.
我们旨在研究三维打印解剖模型在颈动脉支架及栓子保护装置尺寸和位置的术前规划、操作及选择中的潜在作用。
回顾性分析2017年1月至2019年2月期间16例行颈动脉支架置入术并使用栓子保护装置的患者（10例男性，6例女性；平均年龄75.6±4.7岁；范围68至81岁）。尺寸确定基于使用远端保护装置的同一品牌支架的术中血管造影结果。获取用于诊断的术前计算机断层扫描血管造影图像并采用三维打印方法进行建模。比较术前及三维模型中关于支架和保护装置尺寸及植入部位的数据。
发现从三维模型手动测量获得的数据与软件分割图像的数据相似，且两者均小于实际用于支架和栓子保护装置的尺寸。手动测量和软件测量的颈动脉狭窄率相似，但低于血管造影定量测量值。手动测量和软件测量检测到的装置植入部位与实际情况不同。
使用三维模型进行手术规划和操作可减少操作者相关变量，缩短手术时间，减少X线暴露，并提高手术成功率。
