Andrei Giovani1, Aurelia Mihaela Sandu2, George Petrescu2, Radu Mircea Gorgan2, Atul Goel3. 1. Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania. Electronic address: giovani.andrei@gmail.com. 2. Department of Neurosurgery, Emergency Clinical Hospital Bagdasar-Arseni, Bucharest, Romania. 3. Department of Neurosurgery, King Edward Memorial Hospital, Mumbai, India.
Abstract
BACKGROUND: With the development of endovascular neurosurgery, fewer patients have been requiring surgery, and those who do require surgery have more complex cases. Thus, neurosurgeons better trained in microneurosurgery and clipping skills are needed. METHODS: From 2014 to 2017, we built 296 aneurysms models from vessels harvested from chicken wings. The aneurysm models were created by anastomosing segments of arteries and veins with the same aneurysmal geometry and vascular relationships as in actual cases, using 3-dimensional computed tomography angiography. The models were injected with saline using a continuous infusion system, and different clipping techniques were attempted by different neurosurgeons. We have also described new technical solution for treatment of giant aneurysms, a surgical method that excludes them from flux using microsurgical endovascular bypass. RESULTS: We have described, in detail, the design for building middle cerebral artery, posterior communicating artery, anterior communicating artery, and basilar tip aneurysm models. All aneurysm models were patent, with no leakage points and with a good resemblance to the 3-dimensional computed tomography angiographic images that had served as the basis for the models. The aneurysm models were successfully clipped using different techniques. The neurosurgeons that trained on the aneurysm model before surgery found this experience useful. CONCLUSIONS: Aneurysm models respecting the real-case aneurysmal geometry provide a good training method for learning and preparing for surgery.
BACKGROUND: With the development of endovascular neurosurgery, fewer patients have been requiring surgery, and those who do require surgery have more complex cases. Thus, neurosurgeons better trained in microneurosurgery and clipping skills are needed. METHODS: From 2014 to 2017, we built 296 aneurysms models from vessels harvested from chicken wings. The aneurysm models were created by anastomosing segments of arteries and veins with the same aneurysmal geometry and vascular relationships as in actual cases, using 3-dimensional computed tomography angiography. The models were injected with saline using a continuous infusion system, and different clipping techniques were attempted by different neurosurgeons. We have also described new technical solution for treatment of giant aneurysms, a surgical method that excludes them from flux using microsurgical endovascular bypass. RESULTS: We have described, in detail, the design for building middle cerebral artery, posterior communicating artery, anterior communicating artery, and basilar tip aneurysm models. All aneurysm models were patent, with no leakage points and with a good resemblance to the 3-dimensional computed tomography angiographic images that had served as the basis for the models. The aneurysm models were successfully clipped using different techniques. The neurosurgeons that trained on the aneurysm model before surgery found this experience useful. CONCLUSIONS:Aneurysm models respecting the real-case aneurysmal geometry provide a good training method for learning and preparing for surgery.
Authors: Jarnail Bal; Michael Bruneau; Moncef Berhouma; Jan F Cornelius; Luigi M Cavallo; Roy T Daniel; Sebastien Froelich; Emmanuel Jouanneau; Torstein R Meling; Mahmoud Messerer; Pierre-Hugues Roche; Henry W S Schroeder; Marcos Tatagiba; Idoya Zazpe; Dimitrios Paraskevopoulos Journal: Acta Neurochir (Wien) Date: 2022-01-25 Impact factor: 2.216