Low-cost digital tool kit for planning and sizing with 3D printing of abdominal aortic aneurysms for endovascular aortic repair: A Latinoamerican experience

Introduction and objectives: 3D printing technology has recently been used to improve diagnosis and treatment of complex surgical cardiovascular diseases. This technology allows better appreciation of complex 3D anatomical and pathological conditions. The aim of the present study is to show a Latin American experience with a low-cost digital toolkit for planning and sizing with 3D printing of abdominal aortic aneurysms (AAA) for endovascular aortic repair (EVAR) and preoperative simulation, combining 2D and 3D technologies. Methods: Prospective descriptive study. All patients that underwent EVAR between January and May 2021 were included. The EVAR procedures were planned using the low-cost digital tool kit with 3D printing. Results: The 3D printed models had fair transparency, absence of flexibility and no discrepancy between the computer-aided design. The models allowed external inspection but not the insertion of stent grafts due to the lack of lumen. The model had lower cost (25 USD per model), shorter manufacturing time (22 h 31 min), and an acceptable level of accuracy (2.61% error) compared to other methods. Discussion: Using low-cost digital tool kits for planning and sizing with 3D printing, produces a robust physical model of a patient-specific AAA to aid endovascular aneurysm repair education and planning in a timely and cost-effective manner. Conclusions: Overall, with the levels of transparency and flexibility provided by the 3D printed part, the patient-specific AAA model could potentially be used for surgical planning for individual patients but not for surgeons practicing endovascular aneurysm repair stent graft.