Obtaining Informed Consent Using Patient Specific 3D Printing Cerebral Aneurysm Model

Abstract

Objective: Recently, three-dimensional (3D) printed models of the intracranial vascular have served as useful tools in simulation and training for cerebral aneurysm clipping surgery. Precise and realistic 3D printed aneurysm models may improve patients' understanding of the 3D cerebral aneurysm structure. Therefore, we created patient-specific 3D printed aneurysm models as an educational and clinical tool for patients undergoing aneurysm clipping surgery. Herein, we describe how these 3D models can be created and the effects of applying them for patient education purpose.

Methods: Twenty patients with unruptured intracranial aneurysm were randomly divided into two groups. We explained and received informed consent from patients in whom 3D printed models-(group I) or computed tomography angiography-(group II) was used to explain aneurysm clipping surgery. The 3D printed intracranial aneurysm models were created based on time-offlight magnetic resonance angiography using a 3D printer with acrylonitrile-butadiene-styrene resin as the model material. After describing the model to the patients, they completed a questionnaire about their understanding and satisfaction with aneurysm clipping surgery.

Results: The 3D printed models were successfully made, and they precisely replicated the actual intracranial aneurysm structure of the corresponding patients. The use of the 3D model was associated with a higher understanding and satisfaction of preoperative patient education and consultation. On a 5-point Likert scale, the average level of understanding was scored as 4.7 (range, 3.0-5.0) in group I. In group II, the average response was 2.5 (range, 2.0-3.0).

Conclusion: The 3D printed models were accurate and useful for understanding the intracranial aneurysm structure. In this study, 3D printed intracranial aneurysm models were proven to be helpful in preoperative patient consultation.

Keywords: Informed consent; Intracranial aneurysm; Printing, Three-dimensional.

Fig. 1.

Magnetic resonance angiography (MRA) of a right internal carotid artery bifurcation aneurysm before surgery. White arrows showed aneurysms on MRA. A : Anteroposterior view. B : Posteroanterior view.

Fig. 2.

Three-dimensional reconstruction of a right internal carotid artery bifurcation aneurysm before surgery using Materialise Mimics software (Materialise, Leuven, Belgium). A : Anteroposterior view. B : Posteroanterior view.

Fig. 3.

The three-dimensional printed model of an internal carotid artery bifurcation aneurysm before surgery. White arrows demonstrated aneurysms on 3D model. A : Anteroposterior view. B : Posteroanterior view.