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3D printing: a useful tool for safe clinical practice in children with complex vasculature
  1. Alicia Paessler1,
  2. Colin Forman2,3,
  3. Kishore Minhas4,
  4. Premal Amrishkumar Patel4,
  5. James Carmichael5,
  6. Luke Smith5,
  7. Fayyad Jaradat1,
  8. Sergio Assia-Zamora6,
  9. Zainab Arslan1,7,
  10. Francis Calder1,8,
  11. Samiran Ray9,
  12. Nicos Kessaris1,10,
  13. Jelena Stojanovic1,7
  1. 1 Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  2. 2 Vascular Surgery, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  3. 3 Vascular Surgery, Royal Free London NHS Foundation Trust, London, UK
  4. 4 Interventional Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  5. 5 Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  6. 6 Transplant Surgery, King's College Hospital NHS Foundation Trust, London, UK
  7. 7 University College London Institute of Child Health, London, UK
  8. 8 Transplant Surgery, Guy's and St Thomas' Hospitals NHS Trust, London, UK
  9. 9 Paediatric Intensive Care Unit, Great Ormond Street Hospital For Children NHS Trust, London, UK
  10. 10 Transplantation, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Jelena Stojanovic, Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; jelena.stojanovic{at}gosh.nhs.uk

Abstract

Background 3D printing has been used in different medical contexts, although it is underutilised in paediatrics. We present the first use of 3D printing in the management of three paediatric patients with complex renovascular disease.

Methods Patient-specific 3D models were produced from conventional 2D imaging and manufactured using 3D polyjet printing technology. All three patients had different underlying pathologies, but all underwent multiple endovascular interventions (renal artery balloon angioplasty) prior to 3D printing and subsequent vascular surgery. The models were verified by an expert radiologist and then presented to the multidisciplinary team to aid with surgical planning.

Results Following evaluation of the 3D-printed models, all patients underwent successful uni/bilateral renal auto-transplants and aortic bypass surgery. The 3D models allowed more detailed preoperative discussions and more focused planning of surgical approach, therefore enhancing safer surgical planning. It influenced clinical decision-making and shortened general anaesthetic time. The families and the patients reported that they had a significantly improved understanding of the patient’s condition and had more confidence in understanding proposed surgical intervention, thereby contributing to obtaining good-quality informed consent.

Conclusion 3D printing has a great potential to improve both surgical safety and decision-making as well as patient understanding in the field of paediatrics and may be considered in wider surgical areas.

  • Paediatrics
  • Nephrology
  • Technology

Data availability statement

Data are available upon reasonable request. Anonymised data may be shared on an individual basis if needed. Please contact the corresponding author to arrange this.

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Data availability statement

Data are available upon reasonable request. Anonymised data may be shared on an individual basis if needed. Please contact the corresponding author to arrange this.

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Footnotes

  • X @AliciaPaessler, @kish_minhas, @Premal__Patel, @DrSamRay, @dr_JelaS

  • Contributors JS coordinated the whole manuscript. CF, KM, PAAP, JC, FJ, SA-Z, ZA, FC, SR, NK and JS were all involved in the clinical team caring for the patients. SA-Z, FJ and AP collected the data. AP wrote the manuscript and co-ordinated with all authors for their input. KM and PAAP provided the images for the manuscript. JS and AP coordinated the revision. JS is responsible for the overall content and is the guarantor of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer-reviewed.