Application Of 3D Printing Technique In Diagnosis And Treatment Of Aortic Dissection

BackgroundAortic Dissection is a very high mortality rate of cardiovascular disease,the vast majority of patients need to diagnose a clear premise of surgery as soon as possible.At present,the most mainstream of the international classification of the AD is divided into StandFord Type A and StandFord Type B,each type has different sub-types,respectively,corresponding to different surgical treatments.At present,the clinical mainly rely on CT images to refine the classification of the AD and the development of surgical treatment,because the CT image is a two-dimensional image,not intuitive,three-dimensional,especially for the aortic root and bow these irregular of the anatomical parts of the refinement of the process of typing often mistakes.3D printing technology appears,which widely used in the major clinical departments related to the diagnosis and treatment of diseases,with its true reduction of lesion parts,three-dimensional,intuitive,and other advantages,has been widely recognized clinicians.But there are only sporadic case reports of the application of AD.Based on the clinical needs,we reconstructed the AD model based on 3D printing technology for the preoperative refinement typing diagnosis and surgical program development,and the application value of 3D printing technique in the clinical diagnosis and treatment of AD Analysis.ObjectiveOn the basis of this,the application value of 3D printing technique in the clinical diagnosis and treatment of patients with AD was discussed on the basis of the three-dimensional pathology model of the patients with AD.MethodsA total of 30 patients with Type A AD and 60 patients with Type B AD were treated by operation from January 2015 to July 2016 in Zhengzhou City,the seventh People's Hospital.In the 30 patients with Type A interlayer,all the enhanced CT scans were performed and the AD model was reconstructed by 3D printing.According to the patient's CT image and 3D printing model,respectively,in the preoperative aortic root refinement type,pre-established surgical program,pre-selection of artificial blood vessel models and other medical activities.The group data of the diagnosis based on the CT image was used as the CT group,and the group data according to the 3D printing model was used as the 3D printing group.Combined with the actual situation of surgery,verify the refinement of the classification of various groups,surgical programs and artificial blood vessels and intraoperative consistency,the consistency of the various groups as a control,line statistical analysis.Of the 60 patients with Type B aortic dissection,32 patients underwent enhanced CT tomography in the CT group,while the remaining 28 patients were the 3D print group.After enhanced CT scan,the same percentage of aortic dissection was made using 3D printing Pathology model.The two groups were divided according to CT images and 3D aortic model,respectively,and the surgical procedures were established,then we compared the actual situation in the surgery to obtain a detailed classification of similarity and surgical program consistency data.And the patients were followed up for 6 months after surgery to calculate the incidence of postoperative leakage in each group.ResultsIn the 30 patients with Type A dissection,24 cases of CT group were consistent with intraoperative consistency,6 cases were inconsistent,the consistent rate was 80%;23 cases of surgical plan group were consistent,7 cases were inconsistent,and the rate of coincidence was 76.7%.Artificial vascular model consistent with 26 cases,inconsistent with 4 cases,and the same rate of 86.67%.There were 29 cases of similarity in 3D printing group,1 case of inconsistency and 96.67% of consistent rate,29 cases were consistent with the operation plan,1 case was inconsistent,the consistency rate was 96.67%;29 cases of artificial vascular model consistent,inconsistent in 1 case,the same rate of 96.67%;Compared with CT group,the 3D printing group was more accurate in terms ofconsistency of preoperative and intraoperative(P <0.05).Among the 60 patients with Type B AD,in the CT group of 32 cases,28 had the same type of syndromes,4 were inconsistent,the agreement rate was 87.5%;28 cases were consistent with the hand plan,4 cases were inconsistent,the consistency rate 87.5%;There were 5 cases of internal leakage after operation,and the remaining 27 cases had no endoleak occurred.The incidence of endoleak was 15%.There were 28 cases of 3D printing group,with 27 cases of meta-classification and 1 case of inconsistency.The coincidence rate was 96.43%.There were 28 cases of inconsistent operation,in which the consistent rate was 100%,with 0 cases of internal leakage.Comparing with CT group,the incidence of postoperative leakage was lower in B-type aortic dissection(P <0.05).ConclusionThe 3D printing technology have obvious advantages in helping aortic dissection classification and making surgical plan of both two types of AD,so it is worth being referred to and learned in clinical diagnosis and treatment process of the AD,especially for the prevention of Type B dissection after the occurrence of leakage,it has a positive clinical significance.