Recent advances in 3D printing have led to an increased utilization of this technology in Neurological Surgery (1, 2). Specifically, the ability to quickly and inexpensively print patient-specific lesions has the potential to enhance the preoperative planning process, the patient education process and the educational experience for our trainees (figure 1). We report a 54-year-old man who presented with a subarachnoid hemorrhage from a ruptured 1.8 mm left A1 aneurysm. He was also found to have an unruptured 1.6 mm left pericallosal aneurysm, a 6 mm, broad-necked unruptured left middle cerebral artery aneurysm (figure 2), and an unruptured 3.2 mm left ophthalmic segment aneurysm. The A1 and pericallosal artery aneurysms were coiled.
Following recovery from his SAH and four months after coil embolization, the left MCA aneurysm was clipped. As part of the preoperative planning, a 3D model of his MCA aneurysm was printed (figure 3). This model was very helpful in devising intraoperative clipping strategies. The aneurysm was clipped and the MCA bifurcation reconstructed using four clips and without the use of any fixed brain retraction (figure 4). Intraoperative and postoperative angiography showed complete obliteration of the aneurysm with preservation of the M2 branches (figure 5).
1. Ryan JR, Almefty KK, Nakaji P, Frakes DH: Cerebral aneurysm clipping surgery simulation using patient-specific 3D printing and silicone casting. World Neurosurg. 2016 Apr;88:175-81. doi: 10.1016/j.wneu.2015.12.102. Epub 2016 Jan 22.
2. Klein GT, Lu Y, Wang MY: 3D printing and neurosurgery—ready for prime time? World Neurosurg. 2013 Sep- Oct;80(3-4):233-5. doi: 10.1016/j.wneu.2013.07.009. Epub 2013 Jul 16.