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Thoraco-abdominal aneurysm, preoperative model. 1.0.0

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This is a preoperative model of thoraco-abdominal aneurysm, Crawford typle I, with rupture above the diaphragm. The subsequent haemorrhagia in the mediastinum closed temporary the rupture, probably saving the life of the patient. This was an impossible operation, which took 7 hours and the team of the best cardio-thoracic surgeons in Bulgaria. I don't know how, but the patient is still alive and kicking. It took me 3 days to make the model and to turn it into a 3d visualization and I'll share my workflow with you. I'm printing the model right now for a cardio-thoracic surgery symposium.
The source is Angio CT scan with 1,3 mm slide thickness.
1. I analysed the model in Radiant Dicom viewer (you can activate trial license for unlimited amount of times, if you can't afford 100 euro for it). I selected the best series and exported them in a folder.
2. I loaded the model in 3D Slicer. First, I run two denoising algoritms (Gradient Anisotropic Diffusion and Curvature Anisotropic Diffusion), which improved the quality of the images significantly. Then I selected a ROI, which included the whole aorta. With the Segment Editor Module I segmented the lumen of the aorta. Then, as a separate segmentation, I used the Margin operation to grow the lumen with 2 centimeters and applied a boolean operation, resulting in a hollow shell with precise lumen. I had to segment the rest of the aortic wall manually. I exported the result as STL file.
3. In Meshmixer, I modeled the whole thing, until I was satisfied by the result.
4. My client asked me to remove the aortic arch (it's such a pain, I love aortic arches) and to print the aneurysmal sac with the abdominal aorta and the bifurcation of the iliac arteries. Note the double renal artery. I divided the model into two parts and installed ports for two 8x2mm and two 5x2 mm neodymium magnets with tolerance of 0,250mm. The final preprint version is on picture 3.
5. I'm printing this model with 1,5mm slide thickness, 4 perimeters, 15% gyroid infill, custom support with support enforcers, using red Natural PLA from a local manufacturer. The whole printing will take 45 hours.




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The whole time I was thinking that I'm doing something wrong, because it's impossible for a TAAA to be that big. This was beyond everything I ever saw for 22 years of medical education and experience. But yes, it's THAT big. I segmented the lumen, I added 2 cm margin around it to create a hollow shell, then I added the media of the aneurysmic sack and all the atherosclerotic plaques for extra realism. There was a part of the sack, which went into one of the perihepatic space, but I removed it, because my colleague asked me to. The result is marvelous model, bigger than my fist and I'm really proud with it. :)67727272_10220128937790541_9070224871857848320_o.thumb.jpg.c6b7316b0020ab40f25db108c01ea894.jpg

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