{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:06:54Z","timestamp":1788930414019,"version":"build-2803163510"},"reference-count":16,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Cantonal Hospital Aarau","award":["FR_1410.0000.162"],"award-info":[{"award-number":["FR_1410.0000.162"]}]},{"name":"Cantonal Hospital Aarau","award":["FR_1410.0000.18"],"award-info":[{"award-number":["FR_1410.0000.18"]}]},{"name":"Cantonal Hospital Aarau","award":["FR_1410.0000.104"],"award-info":[{"award-number":["FR_1410.0000.104"]}]},{"award":["FR_1410.0000.162"],"award-info":[{"award-number":["FR_1410.0000.162"]}],"id":[{"id":"https:\/\/ror.org\/056tb3809","id-type":"ROR","asserted-by":"publisher"}]},{"award":["FR_1410.0000.18"],"award-info":[{"award-number":["FR_1410.0000.18"]}],"id":[{"id":"https:\/\/ror.org\/056tb3809","id-type":"ROR","asserted-by":"publisher"}]},{"award":["FR_1410.0000.104"],"award-info":[{"award-number":["FR_1410.0000.104"]}],"id":[{"id":"https:\/\/ror.org\/056tb3809","id-type":"ROR","asserted-by":"publisher"}]},{"name":"B. Braun"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sci.","Brain Sciences"],"abstract":"<jats:p>Background: Mixed-reality head-mounted display (MR-HMD) visualization and 3D-printed models may improve three-dimensional visualization in neurosurgical planning. Detailed, reproducible descriptions of the workflows, technical requirements, and practical limitations of these techniques in aneurysm clip ligation planning remain limited. Methods: Between February 2020 and June 2021, patient-specific MR-HMD visualizations and 3D-printed models were generated for 29 patients undergoing elective surgical clip ligation of intracranial aneurysms. CT and 3D rotational angiography were fused to create patient-specific holograms for MR-HMD visualization and 3D-printed models. All cases underwent standardized modality-specific processing. Preparation and manufacturing times as well as recorded workflow-related usability observations, technical advantages, and limitations were assessed. Results: The mean total preparation time (mean \u00b1 standard deviation, SD) was 40.6 \u00b1 10.3 min for MR-HMD visualization and 108.8 \u00b1 17.8 min for 3D-printed models, excluding printing, washing, and curing time. The average printing time for 3D-printed models was 894.9 \u00b1 41.6 min. MR-HMD setup in the operating room averaged 7.0 \u00b1 2.8 min. Identified limitations included manual hologram registration and repositioning after table or patient position changes, as well as the inability to track instruments or interact with the hologram. Conclusions: Both modalities could be integrated into a standardized patient-specific workflow and serve complementary functions. MR-HMD visualization supported flexible short-term visualization, whereas 3D-printed models provided a physical model for clip planning and patient education at the cost of longer preparation and production. These findings support a combined workflow in which modality selection is guided by clinical tasks and time constraints.<\/jats:p>","DOI":"10.3390\/brainsci16090932","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:41:18Z","timestamp":1788266478000},"page":"932","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient-Specific 3D-Printed Models and Mixed-Reality Head-Mounted Display Visualization for Aneurysm Clip Ligation Planning: A Methodological Workflow Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Joshua","family":"Haegler","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Kantonsspital Aarau, 5001 Aarau, Switzerland"},{"name":"Department of Neurosurgery, TUM Medical School, Technical University of Munich, 81675 Munich, 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