Abstract WP18: Cerebral Mechanical Thrombectomy Simulator Using Hydrogel Polymers and 3D Printing Technology


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Abstract

Introduction: While stroke remains a leading cause of death and disability, recent advances in endovascular technology an important opportunity to make a significant impact in clinical outcomes. However, training opportunities are rare, preventing dissemination of these techniques. Hands-on training is further complicated by the critical time to therapy associated with stroke treatment. This physical simulator was built for neurosurgical residents and fellows to practice mechanical thrombectomy.Methods: A simplified virtual model of the anterior cerebral circulation was created based on patient imaging. This luminal model was 3D printed using flexible filament and attached to a guide catheter at the proximal carotid to provide endovascular access and an IV tube at the distal M2 branches to permit outflow. A 7Fr sheath was also connected at the anterior cerebral artery to permit placement of a simulated clot model and simulate a proximal M1 occlusion. This entire construct was placed into a container of polyvinyl alcohol (PVA) and after crosslinking the flexible print was removed.Results: Using 3D printing technology and polymer hydrogels, a low-cost, high fidelity stroke model was achieved. Despite its simplified anatomy, the model permitted realistic wire and catheter navigation through the different segments of the internal carotid and middle cerebral arteries. The ACOM sheath provided a convenient method to reliably place an embolism and created a life-like proximal M1 occlusion. Recanalization was performed using the solumbra technique, which is used in live-patient cases.Conclusions: This model demonstrated proof of concept for a mechanical thrombectomy simulation. The angiographic profile and response to endovascular tools created a training experience similar to live endovascular procedures. As the model is perfected visually and mechanically, next steps are to perform validation studies and create a training curriculum.

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