3D Printing-guided endovascular repair of enormous twisted thoracoabdominal aortic aneurysm with branch stenosis and occlusion.

A 67-year-old male patient was admitted with an enormous twisted thoracoabdominal aortic aneurysm (TAAA) with multiple branch arteries stenosis and occlusion. Three-dimensional (3D) printing technology combined with mechanics was used for developing a transparent model of lesion to simulate the segment of diseased aorta. A stent graft was deployed in the 3D model to make a physician-modified stent graft (PMSGs) on table. The locations of the opening of branches were marked twice during operation. The PMSG was successfully deployed during the surgery and repaired the TAAA, with no endoleak and all the branched arteries patency in follow-up. This technique could offer precision individualized therapy and could simplify the procedure process greatly.

3D parametric surface planar topological guide plate to create a PMSG for the emergency endovascular repair of an aortic arch aneurysm.

A 69-year-old male patient was admitted by 10 h severe chest pain. Computed tomography angiography showed a 7.3 cm aneurysm of the aortic arch. We used a three-dimensional parametric surface planar topological guide plate to prepare a guide plate in 40 min. The plate was used to localize the opening of the aortic arch branches on table to create a physician-modified stent graft (PMSG). The aneurysm was successfully repaired by the triple inner branched PMSG, with no endoleak and all the branched arteries patency in follow-up. This technique could not only make accurate fenestration but also meet the need for emergency surgery.