Role of 3D printing technology in preoperative evaluation of Stanford B aortic dissection endovascular isolation therapy

  AIM  To investigate the feasibility and effectiveness of preoperative in vitro simulation assisted endovascular isolation in the treatment of Stanford type B aortic dissection (TBAD).

  METHODS  The clinical and imaging data of 20 patients with tbad who received interventional endovascular isolation therapy were analyzed retrospectively, including 11 males and 9 females, aged (48±12) years. The CTA data of patients' aorta were imported into Mimics software for computer reconstruction, and the pathological aortic model of TBAD patients was made with 3D printing technology. The operation simulation was carried out before operation to determine the best operation scheme and the method of preventing complications.The CT data during hospitalization and follow-up were statistically analyzed. The preoperative data and the data collected 1 month, 3 months, 6 months and 12 months after intervention were analyzed and compared. The measured true and false lumen diameters and false lumen thrombosis of proximal aortic break plane (L1), stent end plane (L2) and celiac trunk artery plane (L3).

  RESULTS  The twenty patients with TBAD were successfully implanted with a covered stent at the proximal breach of dissection through the femoral artery. CTA was reexamined 12 months after operation. The measured diameters of L1（19.3±2.3）mm vs. (40.6±4.8) mm, P<0.05、L2（18.3±2.2）mm vs.（30.32±4.59）mm, P<0.05、L3 （11.3±1.2）mm vs. (15.2±1.6）mm, P<0.05 were increased compared with those before operation, The measured diameter of plane L1（21.5±3.3） mm vs.（4.9±2.6）mm, P<0.05、L2（21.1±3.0） mm vs. (5.1 ± 2.5） mm, P<0.05、L3（18.5±1.3） mm vs. (15.9±1.6）mm, P<0.05in false cavity decreased compared with that before operation. After stent implantation, the false cavity gradually began to thrombosis. During postoperative follow-up, no serious complications occurred in all patients.

  CONCLUSION  The short and medium-term effect of transcatheter lumen isolation in the treatment of adult TBAD is obvious. 3D printing technology is feasible and effective for preoperative auxiliary evaluation of TBAD patients.