Feasibility of a customizable training environment for neurointerventional skills assessment
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Feasibility of a customizable training environment for neurointerventional skills assessment. / Nawka, Marie Teresa; Hanning, Uta; Guerreiro, Helena; Flottmann, Fabian; Van Horn, Noel; Buhk, Jan-Hendrik; Fiehler, Jens; Frölich, Andreas Maximilian.
In: PLOS ONE, Vol. 15, No. 9, 2020, p. e0238952.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Feasibility of a customizable training environment for neurointerventional skills assessment
AU - Nawka, Marie Teresa
AU - Hanning, Uta
AU - Guerreiro, Helena
AU - Flottmann, Fabian
AU - Van Horn, Noel
AU - Buhk, Jan-Hendrik
AU - Fiehler, Jens
AU - Frölich, Andreas Maximilian
PY - 2020
Y1 - 2020
N2 - OBJECTIVE: To meet increasing demands to train neuroendovascular techniques, we developed a dedicated simulator applying individualized three-dimensional intracranial aneurysm models ('HANNES'; Hamburg Anatomic Neurointerventional Endovascular Simulator). We hypothesized that HANNES provides a realistic and reproducible training environment to practice coil embolization and to exemplify disparities between neurointerventionalists, thus objectively benchmarking operators at different levels of experience.METHODS: Six physicians with different degrees of neurointerventional procedural experience were recruited into a standardized training protocol comprising catheterization of two internal carotid artery (ICA) aneurysms and one basilar tip aneurysm, followed by introduction of one framing coil into each aneurysm and finally complete coil embolization of one determined ICA aneurysm. The level of difficulty increased with every aneurysm. Fluoroscopy was recorded and assessed for procedural characteristics and adverse events.RESULTS: Physicians were divided into inexperienced and experienced operators, depending on their experience with microcatheter handling. Mean overall catheterization times increased with difficulty of the aneurysm model. Inexperienced operators showed longer catheterization times (median; IQR: 47; 30-84s) than experienced operators (21; 13-58s, p = 0.011) and became significantly faster during the course of the attempts (rho = -0.493, p = 0.009) than the experienced physicians (rho = -0.318, p = 0.106). Number of dangerous maneuvers throughout all attempts was significantly higher for inexperienced operators (median; IQR: 1.0; 0.0-1.5) as compared to experienced operators (0.0; 0.0-1.0, p = 0.014).CONCLUSION: HANNES represents a modular neurointerventional training environment for practicing aneurysm coil embolization in vitro. Objective procedural metrics correlate with operator experience, suggesting that the system could be useful for assessing operator proficiency.
AB - OBJECTIVE: To meet increasing demands to train neuroendovascular techniques, we developed a dedicated simulator applying individualized three-dimensional intracranial aneurysm models ('HANNES'; Hamburg Anatomic Neurointerventional Endovascular Simulator). We hypothesized that HANNES provides a realistic and reproducible training environment to practice coil embolization and to exemplify disparities between neurointerventionalists, thus objectively benchmarking operators at different levels of experience.METHODS: Six physicians with different degrees of neurointerventional procedural experience were recruited into a standardized training protocol comprising catheterization of two internal carotid artery (ICA) aneurysms and one basilar tip aneurysm, followed by introduction of one framing coil into each aneurysm and finally complete coil embolization of one determined ICA aneurysm. The level of difficulty increased with every aneurysm. Fluoroscopy was recorded and assessed for procedural characteristics and adverse events.RESULTS: Physicians were divided into inexperienced and experienced operators, depending on their experience with microcatheter handling. Mean overall catheterization times increased with difficulty of the aneurysm model. Inexperienced operators showed longer catheterization times (median; IQR: 47; 30-84s) than experienced operators (21; 13-58s, p = 0.011) and became significantly faster during the course of the attempts (rho = -0.493, p = 0.009) than the experienced physicians (rho = -0.318, p = 0.106). Number of dangerous maneuvers throughout all attempts was significantly higher for inexperienced operators (median; IQR: 1.0; 0.0-1.5) as compared to experienced operators (0.0; 0.0-1.0, p = 0.014).CONCLUSION: HANNES represents a modular neurointerventional training environment for practicing aneurysm coil embolization in vitro. Objective procedural metrics correlate with operator experience, suggesting that the system could be useful for assessing operator proficiency.
KW - Adult
KW - Blood Vessel Prosthesis
KW - Catheterization/methods
KW - Cerebral Angiography/methods
KW - Computer Simulation
KW - Education, Medical/methods
KW - Embolization, Therapeutic/methods
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Intracranial Aneurysm/therapy
KW - Male
KW - Middle Aged
KW - Models, Biological
KW - Simulation Training/methods
U2 - 10.1371/journal.pone.0238952
DO - 10.1371/journal.pone.0238952
M3 - SCORING: Journal article
C2 - 32941466
VL - 15
SP - e0238952
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 9
ER -
