Usefulness of Three-Dimensional-Printed Models in Clipping Intracranial Aneurysms via Keyhole Approaches: A Randomized Controlled Study

Abstract

Three-dimensional (3D)-printed modeling in the treatment of cerebrovascular diseases is rapidly developing. The present study aimed to evaluate the clinical and educational efficacy of 3D-printed models in surgical clipping of intracranial aneurysms. A single-center, randomized, controlled study was conducted for patients with a single unruptured aneurysm was clipped via a keyhole approach using a 3D-printed model at a 1:1 scale between September 2021 and August 2022. A total of 28 patients were enrolled (n = 13 in the case group, n = 15 in the control). The usefulness of the model was determined based on treatment outcomes, patient counseling, and physician education. Compared to the control group, the total operation time was shorter (median 91 min versus 125 min; p = 0.02) and the volume of blood loss was lower (median 119.6 mL versus 234.0 mL; p = 0.01) in the case group. Patients’ understanding of the operation improved significantly after counseling using 3D-printed models in all aspects (p ≤ 0.02). Although they failed to achieve a high rate of selecting a proper type of keyhole craniotomy (p = 0.71), trainees subjectively considered that the 3D-printed models were helpful. The 3D-printed aneurysm models were useful in improving the treatment outcomes, patient satisfaction with the preoperative counseling, and education of the surgical trainees.