Patient-Specific Vascular Modeling - Microsurgery: Advances, Simulations, and Applications - page 75

reconstructing three-dimensional coniguration of vessel lumens
and provides good platform for surgical trainings and preclinical
testing. However, the dissection method is not applicable for clinical
purposes and requires rather high time cost and labor cost for
respective modeling. On the other hand, the reproduction of physical
characteristics of vessel tissue have been less discussed in earlier
works despite its importance, although the reproduction of delicate
feel of operating catheters and the dynamic behavior of surgical
instruments (e.g., its slip/stick motion and unwinding motion) are
both important for simulating neurovascular procedures.

3.2 Required Properties for the Vascular Model

The cerebral arterial model that materializes (1) patient-tailored
modeling with sub-millimeter modeling resolution and (2) the
reproduction of physical characteristics of artery tissues should
serve as an innovative platform for simulating neurovascular
intervention before individual procedures and also helpful for
young trainee to practice endovascular intervention procedures. In
this section, we describe the conditions required for such an in vitro
surgical simulator for endovascular intervention.

3.2.1 Patient-Specific Reproduction

Figures 3.1 and 3.2 show some typical coniguration of the cerebral
artery and aneurysm, respectively. As shown in these igures, the
conigurations of cerebral vasculature are quite different for each
case, and this diversity is an outstanding feature of endovascular
intervention, which contributes to making neurovascular procedures
dificult. From this point of view, although the conventional surgical
simulator that imitates the general coniguration of cerebral artery
with simpliied coniguration (such as glass simulator) is helpful to
experience intervention procedures, it is insuficient for acquiring
comprehensive surgical skills, since this kind of generalized
vasculature model does not relect the diversity of vascular
coniguration, especially the diversity of cerebrovascular diseases.
Moreover, since micro-catheter is used for neurovascular
intervention, the diameter of the vascular lumen that can be treated
by the endovascular approach was reduced to lumens with 1 mm