Design optimization for accurate flow simulations in 3D printed vascular phantoms derived from computed tomography angiography

3D printing has been used to create complex arterial phantoms to advance device testing and physiological condition evaluation. Stereolithographic (STL) files of patient-specific cardiovascular anatomy are acquired to build cardiac vasculature through advanced mesh-manipulation techniques. Management of distal branches in the arterial tree is important to make such phantoms practicable. We investigated methods to manage the distal arterial flow resistance and pressure thus creating physiologically and geometrically accurate phantoms that can be used for simulations of image-guided interventional procedures with new devices. Patient specific CT data were imported into a Vital Imaging workstation, segmented, and exported as STL files. Using a mesh-manipulation program (Meshmixer) we created flow models of the coronary tree. Distal arteries were connected to a compliance chamber. The phantom was then printed using a Stratasys Connex3 multimaterial printer: the vessel in TangoPlus and the fluid flow simulation chamber in Vero. The model was connected to a programmable pump and pressure sensors measured flow characteristics through the phantoms. Physiological flow simulations for patient-specific vasculature were done for six cardiac models (three different vasculatures comparing two new designs). For the coronary phantom we obtained physiologically relevant waves which oscillated between 80 and 120 mmHg and a flow rate of ~125 ml/min, within the literature reported values. The pressure wave was similar with those acquired in human patients. Thus we demonstrated that 3D printed phantoms can be used not only to reproduce the correct patient anatomy for device testing in image-guided interventions, but also for physiological simulations. This has great potential to advance treatment assessment and diagnosis.

[1]  Stephen Rudin,et al.  3D printed cardiac phantom for procedural planning of a transcatheter native mitral valve replacement , 2016, SPIE Medical Imaging.

[2]  Stephen Rudin,et al.  Angiographic imaging evaluation of patient-specific bifurcation-aneurysm phantom treatment with pre-shaped, self-expanding, flow-diverting stents: feasibility study , 2011, Medical Imaging.

[3]  S. Schafer,et al.  Evaluation of guidewire path reproducibility. , 2008, Medical physics.

[4]  J. Sherman,et al.  SU‐FF‐I‐127: Patient Specific Angiography Phantoms for Investigating New Endovascular Image‐Guided Interventional (EIGI) Devices , 2007 .

[5]  Ciprian N Ionita,et al.  Particle image velocimetry (PIV) evaluation of flow modification in aneurysm phantoms using asymmetric stents , 2004, SPIE Medical Imaging.

[6]  Stephen Rudin,et al.  Primary stentriever versus combined stentriever plus aspiration thrombectomy approaches: in vitro stroke model comparison , 2014, Journal of NeuroInterventional Surgery.

[7]  Stephen Rudin,et al.  Advanced 3D mesh manipulation in stereolithographic files and post-print processing for the manufacturing of patient-specific vascular flow phantoms , 2016, SPIE Medical Imaging.

[8]  Daniel R. Bednarek,et al.  Investigation of new flow modifying endovascular image-guided interventional (EIGI) techniques in patient-specific aneurysm phantoms (PSAPs) using optical imaging , 2008, SPIE Medical Imaging.

[9]  Stephen Rudin,et al.  Challenges and limitations of patient-specific vascular phantom fabrication using 3D Polyjet printing , 2014, Medical Imaging.

[10]  Daniel R. Bednarek,et al.  Treatment planning for image-guided neuro-vascular interventions using patient-specific 3D printed phantoms , 2015, Medical Imaging.

[11]  Stephen Rudin,et al.  Partially polyurethane-covered stent for cerebral aneurysm treatment. , 2009, Journal of biomedical materials research. Part B, Applied biomaterials.