Surgical planning with three-dimensional printing of a complex renal artery aneurysm

A 50-year-old woman with a solitary left kidney presented with a 1-year history of worsening left flank pain. A computed tomography angiography of her abdomen revealed a 2.8 cm left renal artery aneurysm that occurred at a distal branching point proximal to the renal hilum (A). Physical model generation, using a three-dimensional (3D) Printrbot (Lincoln, Calif), desktop printer and polylactic acid print filament, facilitated detailed inspection of the renal artery aneurysm morphology, dimensions, and location relative to afferent and efferent branches (B/Cover). Intraoperatively, allknownaneurysm-associatedbrancheswereexpeditiously identified. Open aneurysmorrhaphy with patch angioplasty of the left renal arterywas performedwith awarm ischemia time of<14minutes (C). Resected portions of the aneurysmwere comparedwith the 3Dprintedmodel (D). Postoperatively thepatient’s renal function remainedstableandsherecoveredwell. The patient provided consent for her data to be submitted for publication. Physical 3D anatomic models can provide significant benefit for preoperative surgical case planning when complex anatomy is involved. For example, 3D printing has recently been used to develop maxillofacial surgical implants, plan of complex tumor resections, and examine unique defects in congenital heart anatomy. In vascular surgery, 3D printing is not yet widely adopted, although initial reports have demonstrated its utility in planning abdominal aortic aneurysm repairs and anticipating abdominal aortic aneurysm neck anatomy. In the patient reported here, we further demonstrate the utility of 3D printing technologies in operative case planning and detailed anatomic assessments. We anticipate that as this technology becomes more widely available, it will be more widely adopted for vascular surgery operative case planning.