Evaluation of intracranial stenting in a simulated training and assessment environment for neuroendovascular procedures.

Given the inherent complexity of neurointerventional procedures and the associated risks of ionizing radiation exposure, it is crucial to prioritize ongoing training and improve safety protocols. The aim of this study is to assess a training and evaluation Using a transparent model replicating M1 stenosis, we conducted intracranial stenting procedures with four different setups (Gateway & Wingspan, Gateway & Enterprise, Neurospeed & Acclino, and Pharos Vitesse). A video camera was integrated with the angiography system's monitor for real-time visualization, while a foot switch was employed to simulate live fluoroscopy. Three neuroradiologists with varying levels of expertise performed each procedure for three times. The total duration of fluoroscopy as well as the time from passing the stenosis with the wire to completion of the procedure were recorded using a dedicated software designed for this experimental setup. Compared to the Gateway & Wingspan procedure, the total fluoroscopy time reduced significantly with the Gateway & Enterprise, Neurospeed & Acclino, and Pharos Vitesse procedures by 51.56 s, 111.33 s, and 144.89 s, respectively ( Procedures requiring wire exchange maneuvers exhibited nearly twice the fluoroscopy time in comparison to balloon-mounted stenting or stent-placement via PTA balloon catheters. The more experienced neuroradiologist demonstrated significantly quicker performance in line with expectations in a real-life clinical setting, when compared to the less experienced interventionalist. This

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Copyright © 2023 Kyselyova, Frölich, Bester, Brekenfeld, Buhk, Ding, Nagl, Jost, Guerreiro, Ngo, Fiehler and Flottmann.

Déclaration de conflit d'intérêts

J-HB received personal fees from Consultant for Microvention, Stryker, Cerenovus, Acandis, and Medtronic outside the submitted work. JF received personal fees from Consultant for Microvention, Stryker, Cerenovus, Acandis, Penumbra, and Medtronic outside the submitted work. He is a member of the Executive Board of the scientific societies DGNR and ESMINT. AD, FN, and TJ were employed by Acandis, Acandis GmbH & Co. KG. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.