Lee Joonhyuk, Rybicki Frank J, Ravi Prashanth, Chadalavada Seetharam C
Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, 45219, USA.
Department of Radiology, University of Arizona College of Medicine, Phoenix, AZ, 85004, USA.
3D Print Med. 2024 Oct 5;10(1):32. doi: 10.1186/s41205-024-00226-x.
Inferior vena cava filter (IVC) retrieval is most often routine but can be challenging with high morbidity in complex cases, especially those with an extended dwelling time. While risk of morbidity in complex retrievals is decreased with advanced filter retrieval techniques, deciding when and which to use these requires detailed pre-procedural planning. The purpose of our study was to evaluate patient-specific 3D printed anatomic IVC filter models for aiding complex IVC filter retrievals.
All IVC filter retrieval patients between June 2021 and September 2022 at one academic medical hospital were prospectively screened. Nine met criteria for complex retrieval, and their CT images were used to 3D print patient-specific IVC and filter models. Models were used in pre-procedural planning and clinical utility was assessed using the Anatomic Model Utility Likert Questionnaire and estimations of the procedural and fluoroscopy time saved.
The usage of 3D printed models in pre-procedural planning had high clinical utility based on the Likert questionnaire (Anatomic Model Utility Points 366.7 ± 103.1). Using a model significantly increased confidence in planning (p = 0.03) and modified the treatment plan in seven cases. It also led to cost-efficient use of resources in the procedure suite with estimated reduction in procedure and fluoroscopy time of 29.0 [20.3] (p = 0.003) and 10.2 [6.7] (p = 0.002) minutes, respectively.
3D printed anatomic models for patients who require complex IVC filter retrieval demonstrated Likert-based high clinical utility and led to estimated reductions of procedural and fluoroscopy time.
下腔静脉滤器（IVC）取出术大多时候是常规操作，但在复杂病例中可能具有挑战性，且发病率较高，尤其是那些留置时间较长的病例。虽然先进的滤器取出技术可降低复杂取出术的发病风险，但决定何时以及使用哪种技术需要详细的术前规划。我们研究的目的是评估针对患者的3D打印解剖学IVC滤器模型在辅助复杂IVC滤器取出术中的作用。
对2021年6月至2022年9月在一家学术性医学中心医院进行IVC滤器取出术的所有患者进行前瞻性筛查。9例符合复杂取出术标准，其CT图像用于3D打印针对患者的IVC和滤器模型。模型用于术前规划，并使用解剖模型效用李克特问卷以及对节省的手术时间和透视时间的估计来评估临床效用。
根据李克特问卷，术前规划中使用3D打印模型具有较高的临床效用（解剖模型效用得分366.7±103.1）。使用模型显著提高了规划的信心（p = 0.03），并在7例病例中修改了治疗方案。它还使手术套房中的资源得到有效利用，估计手术时间和透视时间分别减少了29.0[20.3]（p = 0.003）和10.2[6.7]（p = 0.002）分钟。
对于需要进行复杂IVC滤器取出术的患者，3D打印解剖模型显示出基于李克特问卷的高临床效用，并导致手术时间和透视时间估计减少。
