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      On the optimization of low-cost FDM 3D printers for accurate replication of patient-specific abdominal aortic aneurysm geometry

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          Abstract

          Background

          There is a potential for direct model manufacturing of abdominal aortic aneurysm (AAA) using 3D printing technique for generating flexible semi-transparent prototypes. A patient-specific AAA model was manufactured using fused deposition modelling (FDM) 3D printing technology. A flexible, semi-transparent thermoplastic polyurethane (TPU), called Cheetah Water (produced by Ninjatek, USA), was used as the flexible, transparent material for model manufacture with a hydrophilic support structure 3D printed with polyvinyl alcohol (PVA). Printing parameters were investigated to evaluate their effect on 3D–printing precision and transparency of the final model. ISO standard tear resistance tests were carried out on Ninjatek Cheetah specimens for a comparison of tear strength with silicone rubbers.

          Results

          It was found that an increase in printing speed decreased printing accuracy, whilst using an infill percentage of 100% and printing nozzle temperature of 255 °C produced the most transparent results. The model had fair transparency, allowing external inspection of model inserts such as stent grafts, and good flexibility with an overall discrepancy between CAD and physical model average wall thicknesses of 0.05 mm (2.5% thicker than the CAD model). The tear resistance test found Ninjatek Cheetah TPU to have an average tear resistance of 83 kN/m, higher than any of the silicone rubbers used in previous AAA model manufacture. The model had lower cost (4.50 GBP per model), shorter manufacturing time (25 h 3 min) and an acceptable level of accuracy (2.61% error) compared to other methods.

          Conclusions

          It was concluded that the model would be of use in endovascular aneurysm repair planning and education, particularly for practicing placement of hooked or barbed stents, due to the model’s balance of flexibility, transparency, robustness and cost-effectiveness.

          Electronic supplementary material

          The online version of this article (10.1186/s41205-017-0023-2) contains supplementary material, which is available to authorized users.

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          Most cited references10

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          Biomechanics of abdominal aortic aneurysm.

          David Vorp (2006)
          Abdominal aortic aneurysm (AAA) is a condition whereby the terminal aorta permanently dilates to dangerous proportions, risking rupture. The biomechanics of AAA has been studied with great interest since aneurysm rupture is a mechanical failure of the degenerated aortic wall and is a significant cause of death in developed countries. In this review article, the importance of considering the biomechanics of AAA is discussed, and then the history and the state-of-the-art of this field is reviewed--including investigations into the biomechanical behavior of AAA tissues, modeling AAA wall stress and factors which influence it, and the potential clinical utility of these estimates in predicting AAA rupture.
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            Modelling of aortic aneurysm and aortic dissection through 3D printing

            Abstract Introduction The aim of this study was to assess if the complex anatomy of aortic aneurysm and aortic dissection can be accurately reproduced from a contrast‐enhanced computed tomography (CT) scan into a three‐dimensional (3D) printed model. Methods Contrast‐enhanced cardiac CT scans from two patients were post‐processed and produced as 3D printed thoracic aorta models of aortic aneurysm and aortic dissection. The transverse diameter was measured at five anatomical landmarks for both models, compared across three stages: the original contrast‐enhanced CT images, the stereolithography (STL) format computerised model prepared for 3D printing and the contrast‐enhanced CT of the 3D printed model. For the model with aortic dissection, measurements of the true and false lumen were taken and compared at two points on the descending aorta. Results Three‐dimensional printed models were generated with strong and flexible plastic material with successful replication of anatomical details of aortic structures and pathologies. The mean difference in transverse vessel diameter between the contrast‐enhanced CT images before and after 3D printing was 1.0 and 1.2 mm, for the first and second models respectively (standard deviation: 1.0 mm and 0.9 mm). Additionally, for the second model, the mean luminal diameter difference between the 3D printed model and CT images was 0.5 mm. Conclusion Encouraging results were achieved with regards to reproducing 3D models depicting aortic aneurysm and aortic dissection. Variances in vessel diameter measurement outside a standard deviation of 1 mm tolerance indicate further work is required into the assessment and accuracy of 3D model reproduction.
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              Analysis of the properties of silicone rubber maxillofacial prosthetic materials.

              Maxillofacial prosthetic materials are used to replace facial parts lost through disease or trauma. Silicone rubbers are the materials of choice, however it is widely accepted that these materials do not possess ideal properties. The objective of this study was to assess the properties of a range of commercially available silicone rubber maxillofacial materials and make recommendations for improvements. Specimens of five commonly used maxillofacial materials were prepared in dental flasks according manufacturers instructions. Tear strength, tensile strength, percentage elongation, hardness, water absorption and water contact angles were determined for each material. The tear strength of Factor II, Cosmesil HC and Nusil were all comparable and significantly higher than Cosmesil St and Prestige (p<0.001). Nusil had a significantly higher tensile strength and elongation in comparison to the other materials (p<0.001) and Cosmesil St and Cosmesil HC were significantly harder (p<0.001). Factor II was significantly less wetted and Prestige and Cosmsesil St had a significantly higher water absorption in comparison to the other materials. None of the commercially available silicone rubber materials possessed ideal properties for use as a maxillofacial prosthetic material. Factor II, however, showed more favourable properties due to it's high tear strength, softness and ease of manipulation.
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                Author and article information

                Contributors
                michael_pars@hotmail.co.uk
                N.Radacsi@ed.ac.uk
                Colin.Robert@ed.ac.uk
                ed.mccarthy@ed.ac.uk
                Anthony.Callanan@ed.ac.uk
                noel.conlisk@ed.ac.uk
                P.Hoskins@ed.ac.uk
                vasileios.koutsos@ed.ac.uk
                Journal
                3D Print Med
                3D Print Med
                3d Printing in Medicine
                Springer International Publishing (Cham )
                2365-6271
                17 January 2018
                17 January 2018
                2018
                : 4
                : 1
                : 2
                Affiliations
                [1 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, The School of Engineering, Institute for Materials and Processes, , The University of Edinburgh, ; Robert Stevenson Road, Edinburgh, EH9 3FB UK
                [2 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, The School of Engineering, Institute for Bioengineering, , The University of Edinburgh, ; Max Born Crescent, Edinburgh, EH9 3FB UK
                [3 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, Centre for Cardiovascular Sciences, , The University of Edinburgh, ; 47 Little France Crescent, Edinburgh, EH16 4TJ UK
                Author information
                http://orcid.org/0000-0002-7358-951X
                Article
                23
                10.1186/s41205-017-0023-2
                5954792
                29782613
                9e66838a-20df-4b26-a159-c10a3a683cf6
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 22 September 2017
                : 26 December 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2018

                3d printing,abdominal aortic aneurysms,rapid prototype,flexible,transparent,accurate,thermoplastic polyurethane

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