Potential Role of 3-Dimensional Printed Vascular Models in Maintenance Hemodialysis Care

Infiltration of a surgically placed hemodialysis vascular access is recognized as a major contributor to the high health care costs associated with dialysis-dependent patients. Three-dimensional (3D) modeling is a critical tool for proceduralists in preparation for surgical interventions. No such modeling is currently available for dialysis specialists to avoid the common complication of vascular access infiltration. Ferumoxytol-enhanced magnetic resonance angiography was used to generate 3D image data that could render a 3D resin-based model of a vascular access without exposing the patient to iodinated or gadolinium-based radiologic contrast. The technique required an abbreviated magnetic resonance angiography procedure interfaced with a 3D printer workstation. An interventional radiology suite was not required. In the described case, the brachial artery was clearly delineated from a cephalic vein to basilic vein bypass with a 3D spatial resolution of 1 mm. In conclusion, we demonstrate that this new technology pathway can provide preprocedural guidance that has the potential to significantly reduce the morbidity and cost associated with vascular access infiltration.