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Clinical Otolaryngology : Official... Jul 2020Epiphora is a common clinical sign whose primary cause is post-canalicular lacrimal obstruction. Treatment is both surgical and non-surgical. In the literature, there is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Epiphora is a common clinical sign whose primary cause is post-canalicular lacrimal obstruction. Treatment is both surgical and non-surgical. In the literature, there is some evidence to suggest that some treatments are superior to others, but there are no direct comparative data in this regard.
OBJECTIVE OF REVIEW
To analyse the success rates of all available treatments to resolve post-canalicular acquired lacrimal obstruction.
TYPE OF REVIEW
Systematic review and meta-analysis.
SEARCH STRATEGY
A literature search was conducted in the US National Library of Medicine (PubMed), EMBASE, SCOPUS and Cochrane databases with a final search performed in January 2020.
EVALUATION METHOD
The search strategy identified articles published later than 2000 with at least 50 procedures performed both surgically (external dacryocystorhinostomy [EXT-DCR], endoscopic dacryocystorhinostomy [END-DCR] and transcanalicular laser dacryocystorhinostomy [TCL-DCR]) and non-surgically (balloon dacryoplasty [DCP], probing-stenting [SP] and polyurethane stent [PoS]). The primary outcome was functional success, defined as symptom resolution or less than MUNK 2 scale; in addition to this, the influence of adjunctive treatments, such as application of mitomycin C and post-procedural silicone stenting, was evaluated.
RESULTS
In total, 14 958 papers were selected, 440 of which were reviewed after screening; 55 were included after full-text review, which involved 9337 procedures. Mean success rate was 48.9% (35.7%-62.3%) for DCP, 54.4% (41.8%-66.5%) for SP, 73.6% (59.7%-84%) for PoS, 80% (75.1%-84%) for TCL-DCR, 89.8% (83.3%-93.9%) for EXT-DCR and 89.5% (87.2%-91.5%) for END-DCR. Among all procedures, a difference was noted between DCP and END-DCR (P < .001), DCP and EXT-DCR (P < .001), SP and END-DCR (P < .001), SP and EXT-DCR (P < .001), END-DCR and PoS (P = .016), and END-DCR and TCL-DCR (P = .001); no differences were noted between END-DCR and EXT-DCR (P = 1.00), EXT-DCR and PoS (P = .121) and EXT-DCR and TCL-DCR (P = .223). Considering surgical procedures, no differences were seen if a silicone stenting was applied, whereas, due to heterogeneity of the literature data, no statistical analysis was feasible for application of mitomycin C.
CONCLUSIONS
Our analyses suggest that, among all procedures available, END-DCR and EXT-DCR should be considered as treatments of choice to resolve distal acquired lacrimal obstruction.
Topics: Alkylating Agents; Dacryocystorhinostomy; Endoscopy; Humans; Lacrimal Duct Obstruction; Mitomycin; Stents
PubMed: 32304619
DOI: 10.1111/coa.13551 -
BMC Public Health Mar 2020The effectiveness of female condoms for preventing HIV and sexually transmitted infections (STIs) remains inconclusive. We examined the effects of female condoms on the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The effectiveness of female condoms for preventing HIV and sexually transmitted infections (STIs) remains inconclusive. We examined the effects of female condoms on the acquisition of HIV and STIs.
METHODS
We searched four databases, two trial registries, and reference lists of relevant publications in October 2018 and updated our search in February 2020. We screened search output, evaluated study eligibility, and extracted data in duplicate; resolving differences through discussion. We calculated the effective sample size of cluster randomised trials using an intra-cluster correlation coefficient of 0·03. Data from similar studies were combined in a meta-analysis. We performed a non-inferiority analysis of new condoms relative to marketed ones using a non-inferiority margin of 3%. We assessed the certainty of evidence using GRADE.
RESULTS
We included fifteen studies of 6921 women. We found that polyurethane female condoms (FC1) plus male condoms may be as effective as male condoms only in reducing HIV acquisition (1 trial, n = 149 women, RR 0.07, 95%CI 0.00-1.38; low-certainty evidence). However, the use of FC1 plus male condoms is superior to male condoms alone in reducing the acquisition of gonorrhoea (2 trials, n = 790, RR 0.59, 95%CI 0.41-0.86; high-certainty evidence) and chlamydia (2 trials, n = 790, RR 0.67, 95%CI 0.47-0.94; high-certainty evidence). Adverse events and failure rates of FC1 were very low and decreased during follow up. Although the functionality of newer female condoms (Woman's, Cupid, Pheonurse, Velvet, and Reddy) may be non-inferior to FC2, there were no available studies assessing their efficacy in preventing HIV and STIs.
CONCLUSION
The use of female plus male condoms is more effective than use of male condoms only in preventing STIs and may be as effective as the male condom only in preventing HIV. There is a need for well conducted studies assessing the effects of newer female condoms on HIV and STIs.
PROSPERO REGISTRATION NUMBER
CRD42018090710.
Topics: Condoms, Female; Female; HIV Infections; Humans; Randomized Controlled Trials as Topic; Sexually Transmitted Diseases
PubMed: 32164652
DOI: 10.1186/s12889-020-8384-7 -
The Cochrane Database of Systematic... Jan 2020It is estimated that up to 1% of people in high-income countries suffer from a leg ulcer at some time in their life. The majority of leg ulcers are associated with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
It is estimated that up to 1% of people in high-income countries suffer from a leg ulcer at some time in their life. The majority of leg ulcers are associated with circulation problems; poor blood return in the veins causes venous ulcers (around 70% of ulcers) and poor blood supply to the legs causes arterial ulcers (around 22% of ulcers). Treatment of arterial leg ulcers is directed towards correcting poor arterial blood supply, for example by correcting arterial blockages (either surgically or pharmaceutically). If the blood supply has been restored, these arterial ulcers can heal following principles of good wound-care. Dressings and topical agents make up a part of good wound-care for arterial ulcers, but there are many products available, and it is unclear what impact these have on ulcer healing. This is the third update of a review first published in 2003.
OBJECTIVES
To determine whether topical agents and wound dressings affect healing in arterial ulcers. To compare healing rates and patient-centred outcomes between wound dressings and topical agents.
SEARCH METHODS
The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature and Allied and Complementary Medicine databases, the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials register to 28 January 2019.
SELECTION CRITERIA
Randomised controlled trials (RCTs), or controlled clinical trials (CCTs) evaluating dressings and topical agents in the treatment of arterial leg ulcers were eligible for inclusion. We included participants with arterial leg ulcers irrespective of method of diagnosis. Trials that included participants with mixed arterio-venous disease and diabetes were eligible for inclusion if they presented results separately for the different groups. All wound dressings and topical agents were eligible for inclusion in this review. We excluded trials which did not report on at least one of the primary outcomes (time to healing, proportion completely healed, or change in ulcer area).
DATA COLLECTION AND ANALYSIS
Two review authors independently extracted information on the participants' characteristics, the interventions, and outcomes using a standardised data extraction form. Review authors resolved any disagreements through discussion. We presented the data narratively due to differences in the included trials. We used GRADE to assess the certainty of the evidence.
MAIN RESULTS
Two trials met the inclusion criteria. One compared 2% ketanserin ointment in polyethylene glycol (PEG) with PEG alone, used twice a day by 40 participants with arterial leg ulcers, for eight weeks or until healing, whichever was sooner. One compared topical application of blood-derived concentrated growth factor (CGF) with standard dressing (polyurethane film or foam); both applied weekly for six weeks by 61 participants with non-healing ulcers (venous, diabetic arterial, neuropathic, traumatic, or vasculitic). Both trials were small, reported results inadequately, and were of low methodological quality. Short follow-up times (six and eight weeks) meant it would be difficult to capture sufficient healing events to allow us to make comparisons between treatments. One trial demonstrated accelerated wound healing in the ketanserin group compared with the control group. In the trial that compared CGF with standard dressings, the number of participants with diabetic arterial ulcers were only reported in the CGF group (9/31), and the number of participants with diabetic arterial ulcers and their data were not reported separately for the standard dressing group. In the CGF group, 66.6% (6/9) of diabetic arterial ulcers showed more than a 50% decrease in ulcer size compared to 6.7% (2/30) of non-healing ulcers treated with standard dressing. We assessed this as very-low certainty evidence due to the small number of studies and arterial ulcer participants, inadequate reporting of methodology and data, and short follow-up period. Only one trial reported side effects (complications), stating that no participant experienced these during follow-up (six weeks, low-certainty evidence). It should also be noted that ketanserin is not licensed in all countries for use in humans. Neither study reported time to ulcer healing, patient satisfaction or quality of life.
AUTHORS' CONCLUSIONS
There is insufficient evidence to determine whether the choice of topical agent or dressing affects the healing of arterial leg ulcers.
Topics: Administration, Topical; Arteries; Bandages, Hydrocolloid; Humans; Leg Ulcer; Occlusive Dressings; Ointments; Randomized Controlled Trials as Topic; Varicose Ulcer; Wound Healing
PubMed: 31978262
DOI: 10.1002/14651858.CD001836.pub4 -
Aesthetic Plastic Surgery Feb 2020Implementation of polyurethane-covered (PU) implants into practice requires a reassessment of the experience and a learning curve period. Occasional publications...
BACKGROUND
Implementation of polyurethane-covered (PU) implants into practice requires a reassessment of the experience and a learning curve period. Occasional publications describe a few difficulties in this regard. However, there are no publications covering the spectrum of errors. The absence of definite information and contradictory findings makes the learning curve longer leading to many unsatisfactory results.
MATERIALS AND METHODS
The systematization is based on the 12 years of experience with over 1000 patients and previously published data. A literature review was conducted using PUBMED with the following keywords: polyurethane or foam or sponge and breast and implant. A total of 285 articles were found (last accessed 08/13/2019). All articles concerning polyurethane implants were studied along with any articles found describing the surgical techniques applied to them. Additional references found in the above-mentioned articles were also included in the study.
RESULTS
All errors can be divided into planning errors, errors in pocket development and surface-dependent errors, for which the polyurethane surface is the main reason. Surface-dependent errors include the errors connected to positioning and biointegration. The possible causes of late seroma with PU implants are discussed.
CONCLUSIONS
The polyurethane surface should not be considered textured in the clinical point of view. Previous experience with non-PU implants cannot be transferred to PU implants. The learning curve is unavoidable. The systematization of errors with PU implants facilitates a decision-making process during the primary and secondary surgery and lowers the risk of the unsatisfactory results.
LEVEL OF EVIDENCE IV
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266.
Topics: Breast Implantation; Breast Implants; Humans; Mammaplasty; Polyurethanes; Prosthesis Design
PubMed: 31591671
DOI: 10.1007/s00266-019-01510-6 -
Supportive Care in Cancer : Official... Feb 2020To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients...
PURPOSE
To identify the most effective dressing for covering long-term central venous catheter exit site to prevent catheter-related infections and skin irritation in patients undergoing hematopoietic stem cell transplantation.
METHODS
Systematic Review. The search was performed in the following electronic databases: CINAHL, Cochrane Library CENTRAL, EMBASE, LILACS, PubMed, Scopus, and Web of Science. Google Scholar was used for the gray literature search.
RESULTS
Seven studies were included which tested different arrangements of dressings: sterilized gauze and adhesive tape with a transparent polyurethane film (n = 2), transparent polyurethane film with a different replacement interval frequency (n = 2), transparent polyurethane film with and without chlorhexidine released continuously by the dressing at the site of intravascular catheter insertion (n = 2), and dressings vs. no dressings (n = 1). The meta-analysis for catheter-related infection prevention showed no difference between type of dressing (RR 1.76, [95% CI 0.82; 3.75], I 0%) and for the replacement frequency at different intervals (RR 1.04, [95% CI 0.67; 1.61], I 0%). The meta-analysis for skin irritation evaluated the transparent polyurethane film replacement frequency and indicated that a longer dressing replacement interval (10 to 15 days) reduces the risk of developing this outcome (RR 0.71, 0.52; 0.96, 95% CI, I 24%).
CONCLUSIONS
Regarding the type of the dressing, there is no evidence indicating the best dressing. Although there is no evidence available for the ideal replacement frequency, the risk to develop skin irritation is reduced in longer dressing replacements intervals.
Topics: Bandages; Catheter-Related Infections; Central Venous Catheters; Hematopoietic Stem Cell Transplantation; Humans; Polyurethanes
PubMed: 31493134
DOI: 10.1007/s00520-019-05065-9 -
Medicine Apr 2019The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related... (Comparative Study)
Comparative Study Meta-Analysis
PURPOSE
The purpose of our study is to carry out a Bayesian network meta-analysis comparing the efficacy of different antimicrobial dressings for prevention of catheter-related blood infections (CRBSI) and rank these antimicrobial dressings for practical consideration.
METHODS
We searched the PubMed, Cochrane library, Embase, earlier relevant meta-analysis and reference lists of included studies for randomized controlled trials (RCTs) that compared dressings for prevention of CRBSI. Two authors independently extracted data from each included RCT according to a predesigned Excel spreadsheet and assessed the methodological quality of included RCTs using the Cochrane risk of bias tool. Data was analyzed using the WinBUGS (V.1.4.3) and the Stata (V.15.0).
RESULTS
Finally, 35 RCTs involving 8494 patients and evaluating 13 dressings were included. Network meta-analysis showed that transparent dressing may be the best way to prevent CRBSI. Suture and bordered polyurethane dressing might have the lowest risk of CRBSI rate per 1000 catheter-days, and sutureless securement device might lead to the lowest incidence of catheter failure.
CONCLUSIONS
This network meta-analysis indicated that transparent dressings may be selected for the prevention of CRBSI in patients with central venous catheters, which is of importance in future research. Although evidence is scant, more attention should be paid to head-to-head comparisons of the most commonly used dressings in this field.
Topics: Adult; Aged; Anti-Bacterial Agents; Bacteremia; Bandages; Catheter-Related Infections; Catheterization, Central Venous; Central Venous Catheters; Female; Humans; Male; Middle Aged; Polyurethanes; Randomized Controlled Trials as Topic
PubMed: 30946317
DOI: 10.1097/MD.0000000000014940 -
International Journal of Molecular... Feb 2019The aim of this PRISMA review was to assess whether the CMI and Actifit scaffolds, when used in clinical practice, improve clinical outcomes and demonstrate the ideal...
The aim of this PRISMA review was to assess whether the CMI and Actifit scaffolds, when used in clinical practice, improve clinical outcomes and demonstrate the ideal biological and biomechanical properties of scaffolds: being chondroprotective, porous, resorbable, able to mature and promote regeneration of tissue. This was done by only including studies that assessed clinical outcome and used a scale to assess both integrity of the scaffold and its effects on articular cartilage via MRI. A search was performed on PubMed, EMBASE, Scopus and clinicaltrials.gov. 2457 articles were screened, from which eight studies were selected: four used Actifit, three used CMI and one compared the two. All studies reported significant improvement in at least one clinical outcome compared to baseline. Some studies suggested that the scaffolds appeared to show porosity, mature, resorb and/or have possible chondroprotective effects, as assessed by MRI. The evidence for clinical translation is limited by differences in study methodology and small sample sizes, but is promising in terms of improving clinical outcomes in the short to mid-term. Higher level evidence, with MRI and histological evaluation of the scaffold and articular cartilage, is now needed to further determine whether these scaffolds exhibit these useful properties.
Topics: Absorbable Implants; Adult; Arthroscopy; Biomechanical Phenomena; Collagen; Female; Humans; Knee Injuries; Magnetic Resonance Imaging; Male; Menisci, Tibial; Polyesters; Polyurethanes; Porosity; Research Design; Tibial Meniscus Injuries; Tissue Scaffolds; Treatment Outcome
PubMed: 30717200
DOI: 10.3390/ijms20030632 -
The Cochrane Database of Systematic... Dec 2018Pressure ulcers, localised injuries to the skin or underlying tissue, or both, occur when people cannot reposition themselves to relieve pressure on bony prominences.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pressure ulcers, localised injuries to the skin or underlying tissue, or both, occur when people cannot reposition themselves to relieve pressure on bony prominences. These wounds are difficult to heal, painful, expensive to manage and have a negative impact on quality of life. Prevention strategies include nutritional support and pressure redistribution. Dressing and topical agents aimed at prevention are also widely used, however, it remains unclear which, if any, are most effective. This is the first update of this review, which was originally published in 2013.
OBJECTIVES
To evaluate the effects of dressings and topical agents on pressure ulcer prevention, in people of any age, without existing pressure ulcers, but considered to be at risk of developing one, in any healthcare setting.
SEARCH METHODS
In March 2017 we searched the Cochrane Wounds Group Specialised Register, CENTRAL, MEDLINE, MEDLINE (In-Process & Other Non-Indexed Citations), Embase, and EBSCO CINAHL Plus. We searched clinical trials registries for ongoing trials, and bibliographies of relevant publications to identify further eligible trials. There was no restriction on language, date of trial or setting. In May 2018 we updated this search; as a result several trials are awaiting classification.
SELECTION CRITERIA
We included randomised controlled trials that enrolled people at risk of pressure ulcers.
DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials, assessed risk of bias and extracted data.
MAIN RESULTS
The original search identified nine trials; the updated searches identified a further nine trials meeting our inclusion criteria. Of the 18 trials (3629 participants), nine involved dressings; eight involved topical agents; and one included dressings and topical agents. All trials reported the primary outcome of pressure ulcer incidence.Topical agentsThere were five trials comparing fatty acid interventions to different treatments. Two trials compared fatty acid to olive oil. Pooled evidence shows that there is no clear difference in pressure ulcer incidence between groups, fatty acid versus olive oil (2 trials, n=1060; RR 1.28, 95% CI 0.76 to 2.17; low-certainty evidence, downgraded for very serious imprecision; or fatty acid versus standard care (2 trials, n=187; RR 0.70, 95% CI 0.41 to 1.18; low-certainty evidence, downgraded for serious risk of bias and serious imprecision). Trials reported that pressure ulcer incidence was lower with fatty acid-containing-treatment compared with a control compound of trisostearin and perfume (1 trial, n=331; RR 0.42, 95% CI 0.22 to 0.80; low-certainty evidence, downgraded for serious risk of bias and serious imprecision). Pooled evidence shows that there is no clear difference in incidence of adverse events between fatty acids and olive oil (1 trial, n=831; RR 2.22 95% CI 0.20 to 24.37; low-certainty evidence, downgraded for very serious imprecision).Four trials compared further different topical agents with placebo. Dimethyl sulfoxide (DMSO) cream may increase the risk of pressure ulcer incidence compared with placebo (1 trial, n=61; RR 1.99, 95% CI 1.10 to 3.57; low-certainty evidence; downgraded for serious risk of bias and serious imprecision). The other three trials reported no clear difference in pressure ulcer incidence between active topical agents and control/placebo; active lotion (1 trial, n=167; RR 0.73, 95% CI 0.45 to 1.19), Conotrane (1 trial, n=258; RR 0.74, 95% CI 0.52 to 1.07), Prevasore (1 trial, n=120; RR 0.33, 95% CI 0.04 to 3.11) (very low-certainty evidence, downgraded for very serious risk of bias and very serious imprecision). There was limited evidence from one trial to determine whether the application of a topical agent may delay or prevent the development of a pressure ulcer (Dermalex 9.8 days vs placebo 8.7 days). Further, two out of 76 reactions occurred in the Dermalex group compared with none out of 91 in the placebo group (RR 6.14, 95% CI 0.29 to 129.89; very low-certainty evidence; downgraded for very serious risk of bias and very serious imprecision).DressingsSix trials (n = 1247) compared a silicone dressing with no dressing. Silicone dressings may reduce pressure ulcer incidence (any stage) (RR 0.25, 95% CI 0.16 to 0.41; low-certainty evidence; downgraded for very serious risk of bias). In the one trial (n=77) we rated as being at low risk of bias, there was no clear difference in pressure ulcer incidence between silicone dressing and placebo-treated groups (RR 1.95, 95% CI 0.18 to 20.61; low-certainty evidence, downgraded for very serious imprecision).One trial (n=74) reported no clear difference in pressure ulcer incidence when a thin polyurethane dressing was compared with no dressing (RR 1.31, 95% CI 0.83 to 2.07). In the same trial pressure ulcer incidence was reported to be higher in an adhesive foam dressing compared with no dressing (RR 1.65, 95% CI 1.10 to 2.48). We rated evidence from this trial as very low certainty (downgraded for very serious risk of bias and serious imprecision).Four trials compared other dressings with different controls. Trials reported that there was no clear difference in pressure ulcer incidence between the following comparisons: polyurethane film and hydrocolloid dressing (n=160, RR 0.58, 95% CI 0.24 to 1.41); Kang' huier versus routine care n=100; RR 0.42, 95% CI 0.08 to 2.05); 'pressure ulcer preventive dressing' (PPD) versus no dressing (n=74; RR 0.18, 95% CI 0.04 to 0.76) We rated the evidence as very low certainty (downgraded for very serious risk of bias and serious or very serious imprecision).
AUTHORS' CONCLUSIONS
Most of the trials exploring the impact of topical applications on pressure ulcer incidence showed no clear benefit or harm. Use of fatty acid versus a control compound (a cream that does not include fatty acid) may reduce the incidence of pressure ulcers. Silicone dressings may reduce pressure ulcer incidence (any stage). However the low level of evidence certainty means that additional research is required to confirm these results.
Topics: Administration, Cutaneous; Aged; Allantoin; Bandages; Dimethyl Sulfoxide; Drug Administration Schedule; Drug Combinations; Fatty Acids; Hexachlorophene; Humans; Incidence; Middle Aged; Olive Oil; Pressure Ulcer; Randomized Controlled Trials as Topic; Silicones; Skin Care; Skin Cream; Squalene
PubMed: 30537080
DOI: 10.1002/14651858.CD009362.pub3 -
Regenerative Medicine Jul 2018Disc herniation is a spine disease that leads to suffering and disability. Discectomy is a Janus-faced approach that relieves pain symptoms but leave the intervertebral... (Review)
Review
AIM
Disc herniation is a spine disease that leads to suffering and disability. Discectomy is a Janus-faced approach that relieves pain symptoms but leave the intervertebral discs predisposed to herniation. This systematic review discussed the mechanical and biological requirements for a polyurethane-based biomaterial to be used in annular repair.
METHODS
Search strategy was performed in PubMed, Web of Science and Scopus databases to define the main mechanical properties, biological findings and follow-up aspects of these biomaterials. The range was limited to articles published from January 2000 to December 2017 in English language.
RESULTS
The search identified 82 articles. From these, a total of 18 articles underwent a full-text analysis, and 16 studies were included in the review.
CONCLUSION
The polyurethane presents suitable properties to be used as an engineered solution to re-establish the microenvironment and biomechanical features of the intervertebral disc.
Topics: Animals; Annulus Fibrosus; Humans; Intervertebral Disc Displacement; Polyurethanes; Regeneration
PubMed: 30132392
DOI: 10.2217/rme-2018-0003 -
Annals of Vascular Surgery Nov 2018Three-dimensional (3D) printing, also known as rapid prototyping or additive manufacturing, is a novel adjunct in the medical field. The aim of this systematic review is...
BACKGROUND
Three-dimensional (3D) printing, also known as rapid prototyping or additive manufacturing, is a novel adjunct in the medical field. The aim of this systematic review is to evaluate the role of 3D printing technology in the field of contemporary vascular surgery in terms of its technical aspect, practicability, and clinical outcome.
METHODS
A systematic search of literatures published from January 1, 1980 to July 15, 2017 was identified from the EMBASE, MEDLINE, and Cochrane library database with reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The predefined selection inclusion criterion was clinical application of 3D printing technology in vascular surgery of large and small vessel pathology.
RESULTS
Forty-two articles were included in this systematic review, including 2 retrospective cohorts and 1 prospective case control study. 3D printing was mostly applied to abdominal aortic aneurysm (n = 20) and thoracic aorta pathology (n = 8), other vessels included celiac, splenic, carotid, subclavian, femoral artery, and portal vein (n = 10). The most commonly quoted materials were acrylonitrile-butadiene-styrene (n = 2), polylactic acid (n = 4), polyurethane resin (n = 3) and nylon (n = 3). The cost per replica ranged from USD $4-2,360. Cost for a commercial printer was around USD $2,210-50,000.
CONCLUSION
3D printing was recognized and gradually incorporated as a useful adjunct in the field of vascular and endovascular surgery. The production of an accurate anatomic patient-specific replica was shown to bring significant impact in patient management in terms of anatomic understanding, procedural planning, and intraoperative navigation, education, and academic research as well as patient communication. Further analysis on cost-effectiveness was indicated to guide decisions on applicability of such promising technology on a routine basis.
Topics: Animals; Aortography; Endovascular Procedures; Humans; Models, Anatomic; Models, Cardiovascular; Patient-Specific Modeling; Printing, Three-Dimensional; Radiographic Image Interpretation, Computer-Assisted; Surgery, Computer-Assisted; Treatment Outcome; Vascular Diseases; Vascular Surgical Procedures
PubMed: 30053547
DOI: 10.1016/j.avsg.2018.04.038