• Vascular Annual Meeting^®
• Registration
• Hotel Reservations
• Schedule-at-a-Glance
• Program-in-Detail
• Wednesday, June 9 - Postgraduate Courses Day
• Thursday, June 10
• Friday, June 11
• Saturday, June 12
• Sunday, June 13
• International Attendee Information
• General Information
• New in 2010
• Call for Abstracts
• Speaker Information
• Exhibitor Information
• Alumni Association Information
• Future Meeting Dates
• 2009 Meeting Information
• Contact Us

Home > Vascular Annual Meeting^® > PP23. Patient Specific Endovascular Simulation...

PP23. Patient Specific Endovascular Simulation Influences the Material Selection of All Interventionalists Performing a Carotid Artery Stent Procedure

Willem Willaert1, Rajesh Aggarwal1, Isabelle Van Herzeele2, Kevin O'Donoghue1, Marwan Kabbar2, Peter Gaines3, Frank Vermassen2, Ara Darzi1, Nick Cheshire1
1Department of Biosurgery and Surgical Technology, Imperial College London, London, United Kingdom; 2Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium; 3Sheffield Vascular Institute, Northern General Hospital, Sheffield, United Kingdom

OBJECTIVES: Virtual reality endovascular simulation permits the integration of patient-specific data into the software and allows rehearsal of carotid artery stent (CAS) procedures before the ‘real’ intervention. The aim of this study is to evaluate the effect of this technology on physicians’ attitudes towards the selection of endovascular materials necessary for a CAS procedure.

METHODS: Twenty eight interventionalists were recruited and divided into three groups: highly experienced (>50 CAS procedures) n=11, moderately experienced (21-50 CAS) n=6 and inexperienced in CAS (5- 20 CAS) n=11. After review of the CT scan of a type II arch with a tortuous common carotid artery (CCA), all subjects performed the same virtual CAS procedure. Before and after the intervention the choice of endovascular tools and fluoroscopy angles were documented with a questionnaire. Quantitative metrics (procedure time, fluoroscopy time, number of cineloops and amount of contrast given) were recorded by the simulator. Participants also rated the realism and training potential of patient specific simulation on a Likert scale from 1 (poor) to 5 (excellent).

RESULTS: For the 28 participants a total of 252 potential changes were identified. In general 76 changes were observed (33%). Change was most notable in the type of guide wire chosen to exchange a sheath 15/28 (54%), optimal C-arm position 13/28 (46%), choice of selective catheter 12/28 (43%), selection of a sheath or guiding catheter 10/28 (36%) and balloon dilatation strategy 10/28 (36%). The type of embolic protection device 3/28 (11%), position of exchange for a guiding catheter or sheath 3/28 (11%) and the sort of guide wire to cannulate the CCA 1/28 (4%), were altered less frequently. Statistical analysis showed that the degree of change was not influenced by the level of operator experience (p>0.05). The quantitative metrics did not differ significantly between the groups (p>0.05). Participants rated the simulator high for realism (median 4) and for the potential to be used as a pre-procedural training tool (median 4).

CONCLUSIONS: Patient specific simulation remarkably influences the endovascular tool selection and C-arm positions in CAS procedures, irrespective of the level of endovascular CAS experience.

AUTHOR DISCLOSURES: W. Willaert, None; R. Aggarwal, None; I. Van Herzeele, None; K. O'Donoghue, None; M. Kabbar, None; P. Gaines, None; F. Vermassen, None; A. Darzi, None; N. Cheshire, None.