Three-dimensional intracranial middle cerebral artery aneurysm models for aneurysm surgery and training

To develop a realistic model of middle cerebral artery (MCA) aneurysms using three-dimensional (3D) printing for surgical planning, research, and training of neurosurgical residents. This study included eight MCA aneurysm cases. The aneurysm together with the adjacent arteries and skull base were printed based on raw computed tomography angiography (CTA) data using a 3D printer with acrylonitrile-butadiene-styrene as the model material. The aneurysm models were used for surgical planning, and craniotomy and clipping practice by neurosurgical residents. Feedback was obtained using a survey. 3D aneurysm models were created for all seven MCA aneurysm patients. There was good agreement in the model aneurysm diameter, width, and neck and the CTA data, with no significant difference (p > 0.05) among the groups. The simulator was useful for choosing the clips to use before surgery. The average response to each of the survey questions was greater than 3.85 (range 3.0-5.0) on a five-point scale. The 3D printed MCA aneurysm models were accurate. Simulation and practice using the 3D models was useful for understanding the aneurysm structure and choosing the clips to use before surgery, especially for junior neurosurgeons.