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. 2020 Mar 4;9(3):686.
doi: 10.3390/jcm9030686.

Simulation and Training of Needle Puncture Procedure with a Patient-Specific 3D Printed Gluteal Artery Model

Paweł Rynio  1 , Aleksander Falkowski  2 , Jan Witowski  3 , Arkadiusz Kazimierczak  1 , Łukasz Wójcik  2 , Piotr Gutowski  1
Affiliations

Simulation and Training of Needle Puncture Procedure with a Patient-Specific 3D Printed Gluteal Artery Model

Paweł Rynio et al. J Clin Med. .

Abstract

The puncture of the gluteal artery (GA) is a rare and difficult procedure. Less experienced clinicians do not always have the opportunity to practice and prepare for it, which creates a need for novel training tools. We aimed to investigate the feasibility of developing a 3D-printed, patient-specific phantom of the GA and its surrounding tissues to determine the extent to which the model can be used as an aid in needle puncture planning, simulation, and training. Computed tomography angiography scans of a patient with an endoleak to an internal iliac artery aneurysm with no intravascular antegrade access were processed. The arterial system, including the superior GA with its division branches, and pelvic area bones were 3D printed. The 3D model was embedded in the buttocks-shaped, patient-specific mold and cast. The manufactured, life-sized phantom was used to simulate the GA puncture procedure and was validated by 13 endovascular specialists. The printed GA was visible in the fluoroscopy, allowing for a needle puncture procedure simulation. The contrast medium was administered, simulating a digital subtraction angiography. Participating doctors suggested that the model could make a significant impact on preprocedural planning and resident training programs. Although the results are promising, we recommend that further studies be used to adjust the design and assess its clinical value.

Keywords: 3D printing; endoleak; endovascular procedure; gluteal artery; needle puncture; simulation; vascular access.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Three-dimensional volume reconstruction of a computed tomography angiography of a patient with type II endoleak to internal iliac artery aneurysm in (A) anterior and (B) posterior views.
Figure 2
Figure 2
Three-dimensionally printed parts and their assembly. (A) Gluteal artery and internal iliac artery aneurysm lumen (B) Bones and arterial system (C) Skin shell, front and upper part with openings visible; (D) Skin shell, rear part (E) Gluteal artery model with outlet and inlet ducts (F) Gluteal artery model glued to the pelvic bone model.
Figure 3
Figure 3
Results of a questionnaire presented as a diverging Likert scale summary.
Figure 4
Figure 4
Silicone model. (A) Front view (B) Lateral rear view (C) Top view (D) Bottom view (E) Side view.
Figure 5
Figure 5
Needle puncture procedure. (A) View of puncturing 3D silicone model (B) Gluteal artery needle puncture under fluoroscopy (C) Gluteal artery filled with contrast.
See this image and copyright information in PMC

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