Development of Low-Cost Anatomical Flow Model for Simulation of Embolization of Upper Gastrointestinal Bleeding

Monday, March 6, 2023

5:35 PM – 5:40 PM

Location: Phoenix Convention Center, North Ballroom 120ABC, Poster Hall

Abstract Presenter(s)

Raining Huo, BA (she/her/hers)

Medical Student
Emory University School of Medicine

Disclosure(s): No financial relationships to disclose

Author/Co-author(s)

JM

John T. Moon, MD

Resident Physician
Emory University
HL

Hanzhou (Hanssen) Li, MD

Resident Physician
Emory University School of Medicine
Deepak Iyer, MD (he/him/his)

Resident Physician
Icahn School of Medicine at Mount Sinai
Zachary L. Bercu, MD, RPVI (he/him/his)

Associate Professor
Emory University School of Medicine
VP

Vraj Patel

Disclosure(s):

Raining Huo, BA: No financial relationships to disclose

John T. Moon, MD: No financial relationships to disclose

Hanzhou (Hanssen) Li, MD: No financial relationships to disclose

Deepak Iyer, MD: No financial relationships to disclose

Zachary L. Bercu, MD, RPVI: Terumo Medical Corporation: Speaking and Teaching (Ongoing); XAct Robotics: Advisory Committee or Review Panel Member (Ongoing)

Learning Objectives: Review the development and use of a low-cost, 3D-printed model to simulate embolization of common gastrointestinal bleeding sites.

Background: Gastrointestinal bleeding (GIB) is a relatively common condition (150/150,000) with a mortality rate between 2% to 15% (Antunes, 2018; Federica et al., 2018; Wortman et al., 2017). Upper gastrointestinal bleeding (UGIB) is more common than lower gastrointestinal bleeding (LGIB), with incidences of 67/100,000 and 36/100,000 population, respectively. Moreover, gastric and duodenal ulcers are responsible for 50-70% of UGIB bleedings (Sudan et al., n.d.). In order to increase trainee procedural proficiency with angiographic interrogation and embolization, we developed a vascular model allowing for navigation to and deployment of embolization material to target UGIB sites.

Clinical Findings/Procedure Details: Computer-assisted drawing on AutodeskFusion360 (San Rafael, CA) was utilized for the development of the femoral artery, aortic supply, and the celiac trunk with its branches. Individual components were then exported into a stereolithography (.stl) file. Subsequently, the model components were printed on a 3D-printer from Formlabs (Somerville, MA) using their proprietary 50A Resin. Tube connecters of varying sizes were utilized to assemble the vascular model, which was subsequently filled with fluid. While an on-site printer was utilized, various printing services offer affordable online options for model assembly.

Conclusion and/or Teaching Points: Following the above methodology, trainees were able to complete a simulation to practice arterial access, vessel catheterization, and embolization of common upper gastrointestinal sites of bleeding. These same resources, methodologies, and techniques are available for adoption by all trainees.