Evaluation of a modular in vitro neurovascular procedure simulation for intracranial aneurysm embolization

TY - JOUR

T1 - Evaluation of a modular in vitro neurovascular procedure simulation for intracranial aneurysm embolization

AU - Nawka, Marie Teresa

AU - Spallek, Johanna

AU - Kuhl, Juliane

AU - Krause, Dieter

AU - Buhk, Jan Hendrik

AU - Fiehler, Jens

AU - Frölich, Andreas

N1 - © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/7

Y1 - 2019/7

N2 - BACKGROUND: Rapid development in endovascular aneurysm therapy continuously drives demand for suitable neurointerventional training opportunities.OBJECTIVE: To investigate the value of an integrated modular neurovascular training environment for aneurysm embolization using additively manufactured vascular models.METHODS: A large portfolio of 30 patient-specific aneurysm models derived from different treatment settings (eg, coiling, flow diversion, flow disruption) was fabricated using additive manufacturing. Models were integrated into a customizable neurointerventional simulator with interchangeable intracranial and cervical vessel segments and physiological circuit conditions ('HANNES'; Hamburg ANatomic Neurointerventional Endovascular Simulator). Multiple training courses were performed and participant feedback was obtained using a questionnaire.RESULTS: Training for aneurysm embolization could be reliably performed using HANNES. Case-specific clinical difficulties, such as difficult aneurysm access or coil dislocation, could be reproduced. During a training session, models could be easily exchanged owing to standardized connectors in order to switch to a different treatment situation or to change from 'treated' back to 'untreated' condition. Among 23 participants evaluating hands-on courses using a five-point scale from 1 (strongly agree) to 5 (strongly disagree), HANNES was mostly rated as 'highly suitable for practicing aneurysm coil embolization' (1.78±0.79).CONCLUSION: HANNES offers a wide variability and flexibility for case-specific hands-on training of intracranial aneurysm treatment, providing equal training conditions for each situation. The high degree of standardization offered may be valuable for analysis of device behavior or assessment of physician skills. Moreover, it has the ability to reduce the need for animal experiments.

AB - BACKGROUND: Rapid development in endovascular aneurysm therapy continuously drives demand for suitable neurointerventional training opportunities.OBJECTIVE: To investigate the value of an integrated modular neurovascular training environment for aneurysm embolization using additively manufactured vascular models.METHODS: A large portfolio of 30 patient-specific aneurysm models derived from different treatment settings (eg, coiling, flow diversion, flow disruption) was fabricated using additive manufacturing. Models were integrated into a customizable neurointerventional simulator with interchangeable intracranial and cervical vessel segments and physiological circuit conditions ('HANNES'; Hamburg ANatomic Neurointerventional Endovascular Simulator). Multiple training courses were performed and participant feedback was obtained using a questionnaire.RESULTS: Training for aneurysm embolization could be reliably performed using HANNES. Case-specific clinical difficulties, such as difficult aneurysm access or coil dislocation, could be reproduced. During a training session, models could be easily exchanged owing to standardized connectors in order to switch to a different treatment situation or to change from 'treated' back to 'untreated' condition. Among 23 participants evaluating hands-on courses using a five-point scale from 1 (strongly agree) to 5 (strongly disagree), HANNES was mostly rated as 'highly suitable for practicing aneurysm coil embolization' (1.78±0.79).CONCLUSION: HANNES offers a wide variability and flexibility for case-specific hands-on training of intracranial aneurysm treatment, providing equal training conditions for each situation. The high degree of standardization offered may be valuable for analysis of device behavior or assessment of physician skills. Moreover, it has the ability to reduce the need for animal experiments.

U2 - 10.1136/neurintsurg-2019-015073

DO - 10.1136/neurintsurg-2019-015073

M3 - SCORING: Journal article

C2 - 31320551

VL - 12

SP - 214

EP - 219

JO - J NEUROINTERV SURG

JF - J NEUROINTERV SURG

SN - 1759-8478

IS - 2

ER -