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


Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
Feb 2020
Historique:
received: 01 05 2019
revised: 14 06 2019
accepted: 17 06 2019
pubmed: 20 7 2019
medline: 22 7 2020
entrez: 20 7 2019
Statut: ppublish

Résumé

Rapid development in endovascular aneurysm therapy continuously drives demand for suitable neurointerventional training opportunities. To investigate the value of an integrated modular neurovascular training environment for aneurysm embolization using additively manufactured vascular models. 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. 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). 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.

Sections du résumé

BACKGROUND BACKGROUND
Rapid development in endovascular aneurysm therapy continuously drives demand for suitable neurointerventional training opportunities.
OBJECTIVE OBJECTIVE
To investigate the value of an integrated modular neurovascular training environment for aneurysm embolization using additively manufactured vascular models.
METHODS 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 31320551
pii: neurintsurg-2019-015073
doi: 10.1136/neurintsurg-2019-015073
doi:

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

214-219

Informations de copyright

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

Déclaration de conflit d'intérêts

Competing interests: The prepared patent is currently being reviewed by the corresponding authority; no other relationships or activities that could appear to have influenced the submitted work.

Auteurs

Marie Teresa Nawka (MT)

Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany.

Johanna Spallek (J)

Technical University Hamburg-Harburg, Hamburg, Germany.

Juliane Kuhl (J)

Technical University Hamburg-Harburg, Hamburg, Germany.

Dieter Krause (D)

Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany.
Technical University Hamburg-Harburg, Hamburg, Germany.

Jan Hendrik Buhk (JH)

Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany.

Jens Fiehler (J)

Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany.

Andreas Frölich (A)

Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany.

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