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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

Brain Arteriovenous Malformation In Vitro Model for Transvenous Embolization Using 3D Printing and Real Patient Data

Rodrigo Rivera, Alvaro Cespedes, Juan Pablo Cruz, Aymeric Rouchaud and Charbel Mounayer
American Journal of Neuroradiology April 2024, DOI: https://doi.org/10.3174/ajnr.A8188
Rodrigo Rivera
aFrom the Neuroradiology Department (R.R., J.P.C.), Instituto de Neurocirugia Dr. Asenjo, Santiago, Chile
bCNRS XLIM UMLR 7252 (R.R., A.R., C.M.), Université de Limoges, Limoges, France
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  • ORCID record for Rodrigo Rivera
Alvaro Cespedes
cDepartment of Design and Manufacturing (A.C.), Universidad Tecnica Federico Santa Maria, Chile
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Juan Pablo Cruz
aFrom the Neuroradiology Department (R.R., J.P.C.), Instituto de Neurocirugia Dr. Asenjo, Santiago, Chile
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Aymeric Rouchaud
bCNRS XLIM UMLR 7252 (R.R., A.R., C.M.), Université de Limoges, Limoges, France
dNeuroradiology Department (A.R., C.M.), CHU Limoges, France.
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Charbel Mounayer
bCNRS XLIM UMLR 7252 (R.R., A.R., C.M.), Université de Limoges, Limoges, France
dNeuroradiology Department (A.R., C.M.), CHU Limoges, France.
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  • FIG 1.
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    FIG 1.

    The process from the DICOM image to the model. A, MIP 3D reconstruction of the left temporal BAVM. Spetzler-Martin I. B, 3D image of the segmentation manual process by using the region growing technique with 3D Slicer Software. C, CAD representation of the BAVM model design after the main characteristics of the original disease. D, Final in vitro model inside the container, with transparent material and an external “normal” channel. BAVM indicates brain arteriovenous malformation.

  • FIG 2.
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    FIG 2.

    Contrast media retrograde test. Injections were done by using an Echelon 10 microcatheter and iodinated contrast. A, We tested 10 different input pressures from 10 different flow percentages, and we graded the retrograde advance from 0–3 as follows: 0 = no significant advance; 1 = 1 venous limb complete filling; 2 = 2 venous limbs complete filling; 3 = complete venous filling plus proximal arterial filling. B–E, Retrograde contrast injections with different MAP values. An increase in nidal contrast penetration was seen with lower MAP values, with a statistically significant correlation (P = .001).

  • FIG 3.
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    FIG 3.

    Transvenous embolization tests. TVE techniques were performed on 12 identical AVM models, divided into 2 groups (2 × 6). A, Group 1, where retrograde embolization was done by using an Apollo 1.5 30 mm microcatheter (★). B, Group 2, with the same position of the Apollo 1.5 30 mm (★) and a venous coil deployed with a Vasco+ microcatheter in a proximal vein position (★★). C, Real photograph after the EVOH embolization of a group 1 case. D, Real photograph after the EVOH embolization of a group 2 case.

Tables

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    Transvenous embolization resultsa

    GroupGroup 1Group 2Significance
    Total time (min:sec)14:4018:29NS
    Number of stops1315.5NS
    Total LEA (mL)1.3 mL1.75 mLNS
    Nidal LEA volume (mL)0.46 mL0.49 mLNS
    Nidal occlusion (%)57.661.95NS
    • a Nonparametric test for different variables between groups by using the Mann-Whitney test. NS = nonsignificant.

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Brain Arteriovenous Malformation In Vitro Model for Transvenous Embolization Using 3D Printing and Real Patient Data
Rodrigo Rivera, Alvaro Cespedes, Juan Pablo Cruz, Aymeric Rouchaud, Charbel Mounayer
American Journal of Neuroradiology Apr 2024, DOI: 10.3174/ajnr.A8188
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Cite this article
Rodrigo Rivera, Alvaro Cespedes, Juan Pablo Cruz, Aymeric Rouchaud, Charbel Mounayer
Brain Arteriovenous Malformation In Vitro Model for Transvenous Embolization Using 3D Printing and Real Patient Data
American Journal of Neuroradiology Apr 2024, DOI: 10.3174/ajnr.A8188

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