Dr. Adnan Siddiqui threaded a tiny device through the convoluted blood vessels in Teresa Flint’s brain at the Gates Vascular Institute to repair a life-threatening aneurysm as if he knew exactly where to go.
And the Buffalo neurosurgeon did.
Siddiqui had rehearsed the complicated procedure on a rubbery replica of Flint’s arteries made in a 3-D printer, a novel step that changed her treatment and may have saved her life.
3-D printing is emerging as a potentially significant technology in health care. The Jacobs Institute, Kaleida Health’s Gates Vascular Institute and University at Buffalo Jacobs School of Medicine and Biomedical Sciences are using Flint’s case to showcase their efforts to play a leading role in the technology’s development.
Researchers envision using 3-D printing to preplan and practice operations, train new doctors, create transplantable organs, build body parts and develop and test new medical devices, such as those used to prevent or treat stroke and heart problems.
“You can print out an exact model of a patient’s anatomy. This is an incredible advance to test new devices,” said Dr. L. Nelson Hopkins III, a neurosurgeon and founder of the Gates Vascular Institute.
Rehearsals on the rubberlike model made on an $87,000 Stratasys Ltd. Objet Eden 260V 3-D printer convinced Flint’s doctors to reconsider their original plan to insert a metallic basket into the aneurysm to seal it off.
“After attempting the procedure on the 3-D replica, we realized it just wasn’t going to work,” said Siddiqui, chief medical officer at the Jacobs Institute, vice chairman of neurosurgery at the UB medical school and director of neurological stroke services at Kaleida Health.
The trial runs on the model led him to use a different device, which was deployed into the aneurysm by navigating a tiny tube called a catheter through an artery in Flint’s groin to the blood vessels in the brain. To do this, doctors use real-time X-rays to visualize the patient’s blood system and manipulate the device, a soft metal mesh, at the tip of a wire threaded inside the tube.
The rehearsals also shortened the procedure time, reducing the radiation dose and the risk of complications.
“This is going to become the standard of care in complicated elective cases where you have time to see what strategies will work,” Siddiqui said during a recent demonstration of the technology.
Flint, 49, a mother of three from Fillmore, was suffering from headaches and loss of vision when doctors diagnosed the aneurysm, in which the wall of an artery weakens so much that it balloons out like a pouch and fills with blood. If an aneurysm ruptures in the brain, it can cause a disabling stroke or death.
“When I found I had an aneurysm, at first I was a little nervous,” Flint said in a video that Stratasys and the Jacobs Institute are using to promote the application.
“It was very scary to be in the position of not knowing, wondering, you know, if everything would be OK. Would life go on as normal?” she said.
The UB Toshiba Stroke and Vascular Research Center obtained the 3-D printer in 2013, and researchers here and elsewhere are working with Stratasys, co-headquartered in Minneapolis and Rehovot, Israel, to examine potential medical uses. Among other things, 3-D printing is being studied to produce bones, ears, implants, blood vessels and body organs.
Stratasys, which makes printers for a host of industries, estimates that the overall global 3-D printing business will grow from $3.1 billion in 2013 to as much as $21 billion by 2020.
“We see the technology providing value across the health care ecosystem,” said Mike Gaisford, director of marketing for the company’s medical solutions group.
The process with Flint involved taking CT scans of her brain and using software to transform the digital files into a life-sized replica made of a photopolymer material that mimics the feel of human tissue.
“The software is similar to the technology used in 3-D gaming,” said Ciprian Ionita, a research assistant professor at UB who was involved in marrying the various technologies needed to produce a patient-specific model and do it in just a matter of hours. The model for the blood vessels is accurate to 1/2,000th of an inch.
“We’re getting faster and faster in optimizing the time,” he said.
The Gates Vascular Institute has been in the forefront of testing and using minimally invasive endovascular procedures for the prevention and treatment of stroke. A lot of hype is associated with three-dimensional printing, and much work remains to be done if 3-D printing is to become routine in medicine. But physicians and others in Buffalo talk excitedly about being on the cutting edge of the technology.
“We now have to provide feedback to Stratasys to make improvements,” said Michael Springer, director of operations and entrepreneurship at the Jacob Institute.
The Jacobs Institute sits on a floor sandwiched between the Gates Vascular Institute and the UB Center for Translational Research in one of the newer buildings on the Buffalo Niagara Medical Campus. It was created to help bring Buffalo-born medical therapies and devices from the lab to the market as quickly as possible.
With plans to obtain another 3-D printer, officials see opportunities to use the technology for more than surgical planning, including training doctors and testing experimental devices.
“This will aid innovation. When you are trying to develop new device prototypes, you want to know if you can get them into the brain,” said Siddiqui.
Meanwhile, Stratasys is seeking ways to improve the printers to make models even more realistic. In the case of blood vessels, for instance, Gaisford said a higher-end 3-D printer can re-create the multilayered structure of an artery wall. That’s important. Physicians would know, for instance, that if they puncture a rubber artery during a trial run, that kind of complication would be likely to occur in the patient.
“The doctors are pushing the science and pushing us to create better materials,” Gaisford said.